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Kumar N, Sardiwalla II. A case report of definitive endoscopic management of a large right liver lobe hydatid cyst - A novel approach. Int J Surg Case Rep 2024; 120:109825. [PMID: 38851071 PMCID: PMC11220540 DOI: 10.1016/j.ijscr.2024.109825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/23/2024] [Accepted: 05/25/2024] [Indexed: 06/10/2024] Open
Abstract
INTRODUCTION Cystic echinococcosis is a public health concern worldwide and is endemic in rural communities in South Africa (Shaw et al., 2006). The management of hydatid liver disease is of vital socio-economic importance within the infected communities (Centers for Disease Control and Prevention [Internet]. Echinococcosis). Often, surgical intervention is needed, and this carries its own morbidity and economic burden in our low-to-middle income setting (Acta Trop., 2003). Definitive endoscopic management is rarely considered and offers an exciting option with decreased morbidity to the patient. PRESENTATION OF CASE This is a case report of a 36-year-old male who presented with a large right lobe liver hydatid cyst causing abdominal discomfort and pain. He also described early satiety and weight loss with malaise. The symptoms had been present for approximately 8-months duration. The diagnosis of a hydatid liver cyst was made on positive serology and imaging (CE1). The disease was managed with medical treatment using a full course of albendazole initially and then endoscopic drainage into the duodenum using a cautery-enhanced lumen apposing metal stent. There has been no recurrence up to the present time and complete symptom and cyst resolution has been noted. DISCUSSION Given the success of this unconventional management, this case report will help in providing a low-morbidity management option in this endemic disease in certain selected cases. It also provides in detail how to use this option as a definitive management pathway. CONCLUSION This management option required dynamic thinking and a new application of a revolutionary technology which has changed endoscopic management of a variety of conditions.
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Affiliation(s)
- Neha Kumar
- Department of General Surgery, Hepatobiliary Unit, Sefako Makgatho Health Sciences University, South Africa.
| | - Imraan Ismail Sardiwalla
- Department of General Surgery, Hepatobiliary Unit, Sefako Makgatho Health Sciences University, South Africa
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2
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Liaqat A, Lanata MM, Waldeck JM, Kilgore J. Atypical Etiology of Fever Without a Source in a Pediatric Patient. Clin Pediatr (Phila) 2024; 63:1021-1024. [PMID: 37706264 DOI: 10.1177/00099228231200402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Affiliation(s)
- Ayesha Liaqat
- Department of Pediatrics, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Mariana M Lanata
- Department of Infectious Diseases, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - J Michael Waldeck
- Department of Pediatric Intensive Critical Care, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Jacob Kilgore
- Department of Infectious Diseases, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
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3
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Kahraman G, Haberal KM, Dilek ON. Imaging features and management of focal liver lesions. World J Radiol 2024; 16:139-167. [DOI: 10.4329/wjr.v16.i6.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/28/2024] [Accepted: 05/22/2024] [Indexed: 06/26/2024] Open
Abstract
Notably, the number of incidentally detected focal liver lesions (FLLs) has increased dramatically in recent years due to the increased use of radiological imaging. The diagnosis of FLLs can be made through a well-documented medical history, physical examination, laboratory tests, and appropriate imaging methods. Although benign FLLs are more common than malignant ones in adults, even in patients with primary malignancy, accurate diagnosis of incidental FLLs is of utmost clinical significance. In clinical practice, FLLs are frequently evaluated non-invasively using ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Although US is a cost-effective and widely used imaging method, its diagnostic specificity and sensitivity for FLL characterization are limited. FLLs are primarily characterized by obtaining enhancement patterns through dynamic contrast-enhanced CT and MRI. MRI is a problem-solving method with high specificity and sensitivity, commonly used for the evaluation of FLLs that cannot be characterized by US or CT. Recent technical advancements in MRI, along with the use of hepatobiliary-specific MRI contrast agents, have significantly improved the success of FLL characterization and reduced unnecessary biopsies. The American College of Radiology (ACR) appropriateness criteria are evidence-based recommendations intended to assist clinicians in selecting the optimal imaging or treatment option for their patients. ACR Appropriateness Criteria Liver Lesion-Initial Characterization guideline provides recommendations for the imaging methods that should be used for the characterization of incidentally detected FLLs in various clinical scenarios. The American College of Gastroenterology (ACG) Clinical Guideline offers evidence-based recommendations for both the diagnosis and management of FLL. American Association for the Study of Liver Diseases (AASLD) Practice Guidance provides an approach to the diagnosis and management of patients with hepatocellular carcinoma. In this article, FLLs are reviewed with a comprehensive analysis of ACR Appropriateness Criteria, ACG Clinical Guideline, AASLD Practice Guidance, and current medical literature from peer-reviewed journals. The article includes a discussion of imaging methods used for the assessment of FLL, current recommended imaging techniques, innovations in liver imaging, contrast agents, imaging features of common nonmetastatic benign and malignant FLL, as well as current management recommendations.
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Affiliation(s)
- Gökhan Kahraman
- Department of Radiology, Suluova State Hospital, Amasya 05500, Türkiye
| | - Kemal Murat Haberal
- Department of Radiology, Başkent University Faculty of Medicine, Ankara 06490, Türkiye
| | - Osman Nuri Dilek
- Department of Surgery, İzmir Katip Celebi University, School of Medicine, İzmir 35150, Türkiye
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Pensel PE, Scioscia NP, Nieto N, Zoppi J, Chaparro M, Paredes AJ, Albani CM, Palma SD, Elissondo MC. Usefulness of a murine model of hepatic cystic echinococcosis for preclinical drug trials: Efficacy of albendazole vs albendazole nanocrystals. Acta Trop 2024; 257:107285. [PMID: 38908420 DOI: 10.1016/j.actatropica.2024.107285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 05/03/2024] [Accepted: 06/08/2024] [Indexed: 06/24/2024]
Abstract
Cystic echinococcosis is a zoonotic infection caused by the larval stage of Echinococcus granulosus sensu lato. The disease is characterized by the long-term growth of cysts, most commonly in the liver and lungs. Although an ideal model of cystic echinococcosis should induce the development of cysts in the liver and imitate the natural infection route, the murine model of intraperitoneal is still widely used in the field of experimental theraphy. The aim of the present work was to evaluate the usefulness of the murine model of hepatic CE for preclinical drug trials. The effectiveness of albendazole could also be assessed by measuring the diameter of the hepatic cyst. The albendazole significantly reduced the size of the cysts. The ultrastructural alterations of the germinal layer of hepatic cysts provoked by albendazole coincided with those observed in the intraperitoneal model. Similar results were obtained with both albendazole doses. Therefore, the efficacy of albendazole nanocrystals in the murine model of hepatic cystic echinococcosis was carried out at albendazole doses of 25 mg/kg. The abdominal ultrasound allows us to assess the response of cysts to drugs only in a qualitative manner. Although the size of cysts in the albendazole nanocrystal group was not significantly lower than that observed with albendazole, at the ultrastructural level, a greater extent of damage was observed. The murine model of hepatic cystic echinococcosis can be effectively used for assessing the effect of novel formulations or compounds. The main advantage of this model is that cysts are located in the orthotopic organ, which resembles the location most commonly found in human cases. In future studies, the usefulness of the model for pharmacokinetics studies in hepatic cysts will be evaluated.
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Affiliation(s)
- Patricia E Pensel
- Instituto de Investigaciones en Producción, Sanidad y Ambiente (IIPROSAM), CONICET-UNMdP, Centro de Asociación Simple CIC PBA, Argentina; Laboratorio de Zoonosis Parasitarias, Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata, Argentina.
| | - Nathalia P Scioscia
- Instituto de Investigaciones en Producción, Sanidad y Ambiente (IIPROSAM), CONICET-UNMdP, Centro de Asociación Simple CIC PBA, Argentina; Laboratorio de Zoonosis Parasitarias, Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata, Argentina
| | - Nicolás Nieto
- Instituto Radiológico, Mar del Plata, Buenos Aires, Argentina
| | - Jorge Zoppi
- Hospital Privado de Comunidad, Mar del Plata, Buenos Aires, Argentina
| | - Mauro Chaparro
- Centro Marplatense de Investigaciones Matemáticas (CEMIM), Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata. CONICET
| | - Alejandro J Paredes
- School of Pharmacy, Queen's University Belfast, Belfast BT9 7BL, United Kingdom
| | - Clara M Albani
- Instituto de Investigaciones en Producción, Sanidad y Ambiente (IIPROSAM), CONICET-UNMdP, Centro de Asociación Simple CIC PBA, Argentina; Laboratorio de Zoonosis Parasitarias, Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata, Argentina
| | - Santiago D Palma
- Unidad de Investigación y Desarrollo en Tecnología Farmacéutica, UNITEFA-CONICET; Departamento de Ciencias Farmacéuticas, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Ciudad Universitaria, HUA-Córdoba, Argentina
| | - María C Elissondo
- Instituto de Investigaciones en Producción, Sanidad y Ambiente (IIPROSAM), CONICET-UNMdP, Centro de Asociación Simple CIC PBA, Argentina; Laboratorio de Zoonosis Parasitarias, Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata, Argentina
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Nagasbekov M, Baimakhanov Z, Doskhanov M, Nurlanbayev E, Kaniyev S, Akhan O, Baimakhanov B, Fakhradiyev I. Cystic echinococcosis of the liver in Kazakhstan: The effectiveness of the PAIR method in comparison with laparoscopic and «open» surgical methods. Asian J Surg 2024:S1015-9584(24)01061-3. [PMID: 38825418 DOI: 10.1016/j.asjsur.2024.05.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/30/2024] [Accepted: 05/23/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND One of the urgent problems of surgical parasitology in the Republic of Kazakhstan is liver cystic echinococcosis. The study aimed to analyze the effectiveness and safety of the percutaneous treatment with different techniques in comparison with the results of laparoscopic and "open" surgical methods. METHODS Retrospectively, we analyzed the outcome of 485 patients with active echinococcal cysts in the period from January 2017-July 2023. Indications for surgical treatment and the choice of the intervention method were based on this classification. Patients were conditionally divided into 3 groups: Laparoscopy-33, Laparotomy-319, PAIR-133. RESULTS The duration of the operation in the PAIR was significantly shorter compared to the Laparotomy and Laparoscopy groups (55.4vs.225.2 and 215.3, p = 0.0001). There was no intraoperative blood loss in PAIR, whereas in Laparotomy and Laparoscopy there were 146.0 and 111.0. The postoperative stay of patients in PAIR is significantly shorter than in Laparotomy and Laparoscopy (3.8 compared to 7.5 and 6.4, p = 0.0001). The follow-up time averaged 39.8 months ± 21. There were no statistically significant differences in relapses. Laparotomy and PAIR groups had 11 (3.5 %) and 6 (4.5 %) relapses, respectively. CONCLUSION In cystic echinococcosis of the liver types CE1, CE3a regardless of the localization, the optimal volume is a PAIR is characterized by a shorter postoperative stay of the patient, early recovery and cure. In the CE2, CE3b stages, laparoscopic pericystectomy is the most effective and safe in individual patients. In case of an intimate arrangement of cysts to tubular structures, the safest method is laparotomy.
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Affiliation(s)
- Madiyar Nagasbekov
- «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan; «S.D.Asfendiyarov Kazakh National Medical University», Almaty, Kazakhstan
| | | | - Maxat Doskhanov
- «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan
| | - Erik Nurlanbayev
- «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan
| | - Shokan Kaniyev
- «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan
| | - Okan Akhan
- «Hacettepe University», Faculty of Medicine, Department of Radiology, Ankara, Turkey
| | - Bolatbek Baimakhanov
- «Syzganov National Scientific Center of Surgery», Almaty, Kazakhstan; «S.D.Asfendiyarov Kazakh National Medical University», Almaty, Kazakhstan
| | - Ildar Fakhradiyev
- «S.D.Asfendiyarov Kazakh National Medical University», Almaty, Kazakhstan.
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Brunner A, Unterberger SH, Auer H, Hautz T, Schneeberger S, Stalder R, Badzoka J, Kappacher C, Huck CW, Zelger B, Pallua JD. Suitability of Fourier transform infrared microscopy for the diagnosis of cystic echinococcosis in human tissue sections. JOURNAL OF BIOPHOTONICS 2024; 17:e202300513. [PMID: 38531615 DOI: 10.1002/jbio.202300513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/14/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
Cystic echinococcosis (CE) is a global health concern caused by cestodes, posing diagnostic challenges due to nonspecific symptoms and inconclusive radiographic results. Diagnosis relies on histopathological evaluation of affected tissue, demanding comprehensive tools. In this retrospective case study, Fourier transform infrared microscopy was explored for detecting and identifying CE through biochemical changes in human tissue sections. Tissue samples from 11 confirmed CE patients were analyzed. Archived FFPE blocks were cut and stained, and then CE-positive unstained sections were examined using Fourier transform infrared microscopy post-deparaffinization. Results revealed the method's ability to distinguish echinococcus elements from human tissue, irrespective of organ type. This research showcases the potential of mid-infrared microscopy as a valuable diagnostic tool for CE, offering promise in enhancing diagnostic precision in the face of the disease's complexities.
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Affiliation(s)
- A Brunner
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - S H Unterberger
- Department of Material-Technology, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - H Auer
- Department of Medical Parasitology, Clinical Institute of Hygiene and Medical Microbiology, Medical University of Vienna, Vienna, Austria
| | - T Hautz
- OrganLifeTM, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - S Schneeberger
- OrganLifeTM, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - R Stalder
- Institute of Mineralogy and Petrography, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - J Badzoka
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innsbruck, Austria
| | - C Kappacher
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innsbruck, Austria
| | - C W Huck
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innsbruck, Austria
| | - B Zelger
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - J D Pallua
- Department of Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria
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Qi X, Song T, Li Z, Jiang T, Zhang Z, Wu C, Guo G, Dong J, Dawuti W, Dou J, Li J, Wen H, Zhang W. Ultrasonography screening of hepatic cystic echinococcosis in sheep flocks used for evaluating control progress in a remote mountain area of Hejing County, Xinjiang. BMC Vet Res 2024; 20:207. [PMID: 38760783 PMCID: PMC11100068 DOI: 10.1186/s12917-024-04074-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 05/10/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Although ultrasonography (US) has been widely used in the diagnosis of human diseases to monitor the progress of cystic echinococcosis (CE) control, the screening method for hepatic CE in sheep flocks requires adjustment. In this study, we used a US scanner to screen sheep flocks and evaluated the efficacy of dosing dogs once a year with praziquantel for 7 years from 2014 to 2021. METHODS All sheep in the three flocks were screened using an ultrasound scanner in 2014 and compared with the prevalence of infection in 2021 in Bayinbuluke, Xinjiang, China. Sheep age was determined using incisor teeth. Cyst activity and calcification were determined using US images. The dogs were dewormed with praziquantel once a year to control echinococcosis in the community. RESULTS Three flocks had 968 sheep in 2014, with 13.22%, 22.62%, 18.7%, 27.27%, 11.88%, and 6.3% of sheep aged 1, 2, 3, 4, 5, and ≥ 6 years old, respectively. US scanning revealed that the overall CE prevalence was 38.43% (372/968), with active cysts and calcified cysts present in 9.40% (91/968) and 29.02% (281/968) of the sheep, respectively. For the young sheep aged 1 and 2 years, the prevalence of active and calcified cysts was: 1.56% and 0.91%, and 10.94% and 18.72%, respectively. Approximately 15.15% and 16.52% of the 4- and 5-year-old sheep, respectively, harbored active cysts. There was no significant difference in the infection rates of sheep between 2014 and 2021 (P > 0.05). CONCLUSIONS US is a practical tool for the field screening of CE in sheep flocks. One-third of the sheep population in the flocks was 1-2 years old, and these sheep played a very limited role in CE transmission, as most of the cysts were calcified. Old sheep, especially culled aged sheep, play a key role in the transmission of CE. Dosing dogs once a year did not affect echinococcosis control.
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Affiliation(s)
- Xinwei Qi
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, 830054, Xinjiang, China
| | - Tao Song
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, 830054, Xinjiang, China
| | - Zhao Li
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, 830054, Xinjiang, China
| | - Tao Jiang
- Animal Center, Xinjiang Medical University, No. 393 Xinyi Road, Urumqi, 830000, Xinjiang, China
| | - Zhuangzhi Zhang
- Veterinary Research Institute, Xinjiang Academy of Animal Sciences, No. 468 Alishan Road, Urumqi, 830011, Xinjiang, China
| | - Chuanchuan Wu
- Basic Medical College, Xinjiang Medical University, No. 567 North Shangde Road, Urumqi, 830039, Xinjiang, China
| | - Gang Guo
- Suzhou Center for Disease Control and Prevention, No. 72 Sanxiang Road, Suzhou, 215004, Jiangsu, China
| | - Jian Dong
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, 830054, Xinjiang, China
| | - Wubulitalifu Dawuti
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, 830054, Xinjiang, China
| | - Jingrui Dou
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, 830054, Xinjiang, China
| | - Jun Li
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, 830054, Xinjiang, China
| | - Hao Wen
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, 830054, Xinjiang, China.
| | - Wenbao Zhang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, 830054, Xinjiang, China.
- Basic Medical College, Xinjiang Medical University, No. 567 North Shangde Road, Urumqi, 830039, Xinjiang, China.
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Velev V, Pelov T, Minova G, Petrov PP, Peev S, Rangelov E, Penchev P. Diagnostic Problem in a Child With an Isolated Renal Hydatid Cyst: A Case Report. Cureus 2024; 16:e60319. [PMID: 38882960 PMCID: PMC11177006 DOI: 10.7759/cureus.60319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
Cystic hydatid disease is a parasitic disease caused by the larvae of the small tapeworm Echinococcus granulosus. It is still a serious public health problem in endemic regions such as the Mediterranean basin, especially in the Balkans. Usually, the complaints caused by the cysts are non-specific and there are rarely abnormalities in routine laboratory tests. The most common is the involvement of the liver. The frequency of isolated kidney involvement, especially in a child, is uncommon. We describe a rare pediatric case of an isolated renal hydatid cyst presenting with a urinary tract infection-like clinical presentation, leading to misdiagnosis and delayed treatment.
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Affiliation(s)
- Valeri Velev
- Department of Infectious Diseases and Parasitology, University Hospital "Prof. Iv. Kirov", Sofia, BGR
- Department of Infectious Diseases and Parasitology, Medical University Sofia, Sofia, BGR
| | - Teofil Pelov
- Department of Pediatric Urology, University Hospital "N. I. Pirogov", Sofia, BGR
| | - Gabriela Minova
- Department of Pediatric Urology, University Hospital "N. I. Pirogov", Sofia, BGR
| | - Petar-Preslav Petrov
- Department of Anatomy, Histology and Embryology, Medical University of Plovdiv, Plovdiv, BGR
| | - Stoyan Peev
- Department of Pediatric Urology, University Hospital "N. I. Pirogov", Sofia, BGR
| | - Edmond Rangelov
- Department of Pediatric Surgery, University Hospital "N. I. Pirogov", Sofia, BGR
| | - Plamen Penchev
- Faculty of Medicine, Medical University of Plovdiv, Plovdiv, BGR
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Bhende VV, Rathod JB, Sharma AS, Thacker JP, Krishnakumar M, Mankad SP, Mehta DV, Kamat HV, Khara BN, Mehta SH, Prajapati D, Kumar A, Chaudhary M, Kotadiya KV, Gohil AB, Vani PP, Panchal SR, Mehta NJ, Patel DA, Gadoya VA, Ghoti HD. Conservative Surgical Management of a Pulmonary Hydatid Cyst in an Adolescent Having Extra-pulmonary Lesions by a Multi-disciplinary Approach. Cureus 2024; 16:e58600. [PMID: 38651089 PMCID: PMC11034718 DOI: 10.7759/cureus.58600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 04/25/2024] Open
Abstract
Echinococcus granulosus causes hydatid cysts, a significant zoonotic and pulmonary parasitic disease that can mimic various pathologies and is often harder to manage than the disease itself. A hydatid cyst is considered a significant health problem in India, Iran, China, and Mediterranean countries, which lack satisfactory environmental health, preventive medicine, and veterinarian services. Echinococcosis continues to be a major community health burden in several countries, and in some terrains, it constitutes an emerging and re-emerging disease. Cystic echinococcosis is the most common human disease of this genus, and it accounts for a significant number of cases worldwide. Herein, a case involving an 11-year-old presenting with fever, dry cough, and right hypochondrial pain is presented, where imaging revealed a hydatid cyst in the lung. Surgical removal of the cyst was achieved through right posterolateral thoracotomy under one-lung ventilation and anesthesia using intubation with a double-lumen endotracheal tube (DLET or DLT), highlighting surgery as the primary treatment despite the lack of consensus on surgical methods. This case underscores the effectiveness of individualized, parenchyma-preserving surgery for even large, uncomplicated cysts, indicating a positive prognosis.
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Affiliation(s)
- Vishal V Bhende
- Pediatric Cardiac Surgery, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Jignesh B Rathod
- Surgery, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Ashwin S Sharma
- Internal Medicine, Gujarat Cancer Society Medical College, Hospital, and Research Centre, Ahmedabad, IND
| | - Jigar P Thacker
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | | | | | - Deepakkumar V Mehta
- Radiodiagnosis and Imaging, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Hemlata V Kamat
- Anesthesiology, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Birva N Khara
- Anesthesiology, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Sanket H Mehta
- Anesthesiology, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Dhavalkumar Prajapati
- Pulmonary Medicine, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Amit Kumar
- Pediatric Intensive Care Unit (PICU), Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Mansi Chaudhary
- Anesthesiology, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Kuldeep V Kotadiya
- Surgery, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Aradhanaba B Gohil
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Prachi P Vani
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Sweta R Panchal
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Nili J Mehta
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Divyanshi A Patel
- Pediatrics, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Vidit A Gadoya
- Surgery, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
| | - Himanshu D Ghoti
- Surgery, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND
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10
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D'Alessandro GL, Pontarelli A, Leka A, Casazza D, Lissandrin R, Manciulli T, Botta A, Parrella R, Brunetti E, Rinaldi P. Delayed Surgical Treatment of a CE1 Lung Cyst Resulting in Pericystectomy of CE4 Cyst. Case Rep Infect Dis 2024; 2024:5167805. [PMID: 38515562 PMCID: PMC10957245 DOI: 10.1155/2024/5167805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/02/2023] [Accepted: 12/16/2023] [Indexed: 03/23/2024] Open
Abstract
Lung is the second most common locationof cystic echinococcosis (CE), after the liver. Diagnosis of lung CE is often incidental, and clinical manifestations depend on the location and size of the cyst, the most common being chest pain, shortness of breath, expectoration of fragments of endocyst, and haemoptysis. Surgery is the primary treatment, with a minor role for medical therapy. Delayed diagnosis and treatment may have important consequences. We present a case of lung CE in whichsurgical treatment was delayed due to the first wave of COVID-19. Since surgery could not be performed immediately, the patient was kept on albendazole and the cyst stage moved from CE1 to CE3a, to CE4, eventually requiring a more aggressive pericystectomy instead of the commonly performed endocystectomy. The clinical and imaging characteristics of a rare CE4 cyst of the lung are reported.
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Affiliation(s)
- Gian Luca D'Alessandro
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Agostina Pontarelli
- Unit of Respiratory Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, Naples, Italy
| | - Armanda Leka
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Dino Casazza
- Unit of Thoracic Surgery, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples, Italy
| | | | - Tommaso Manciulli
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Annarita Botta
- Unit of Respiratory Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, Naples, Italy
| | - Roberto Parrella
- Unit of Respiratory Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, Naples, Italy
| | - Enrico Brunetti
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- San Matteo Hospital Foundation, Pavia, Italy
| | - Pietro Rinaldi
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- San Matteo Hospital Foundation, Pavia, Italy
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11
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Shmueli M, Van Buren J, Sagi O, Grupel D, Sheves A, Assi Z, Ben-Shimol S. Performance of Echinococcosis Serology is Associated with Disease Endemicity, Hydatid Cyst Location, Eosinophilia, Imaging Finding, and Treatment. Acta Parasitol 2024; 69:233-241. [PMID: 37981634 DOI: 10.1007/s11686-023-00736-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 10/26/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND We aimed to assess echinococcosis serology performance for diagnosing cystic echinococcosis (CE) in children living in CE-endemic vs. non-endemic populations, and in different clinical settings. METHODS A retrospective cohort study, assessing children with ELISA test for echinococcosis, 2005-2021. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated comparing CE-endemic vs. non-endemic populations, cases with/without eosinophilia, and cases with/without CE-suggestive imaging findings. Additionally, we examined the association between serology titers/levels (values) and clinical characteristics. RESULTS Of 273 cases, 66 (24%) were confirmed as CE. Overall, 97% of CE were in Bedouin children, and the pre-test probability was 28% vs. 9% (p < 0.001) in CE-endemic vs. non-endemic population, respectively. Sensitivity was higher in hepatic than extra-hepatic CE (74% vs. 47%). Overall specificity was 86%. PPVs were higher in CE-endemic population compared to non-endemic (66% vs. 22%), while NPVs were higher in non-endemic population (100% vs. 87%). Eosinophilia was associated with lower specificity (73% vs. 94%) and PPV (47% vs. 78%). Typical imaging was associated with higher specificity (94% vs. 82%) and PPV (91% vs. 11%), while NPVs were lower in typical imaging cases (77% vs. 98%). Higher titer levels (above median) were associated with typical imaging (76% vs. 49%), higher PPV (79% vs. 43%), albendazole treatment (100% vs. 56%), surgery (60% vs. 19%), and new imaging finding (75% vs. 0%). CONCLUSIONS Echinococcosis serology performance was impacted by disease endemicity, and by various clinical characteristics. These findings may assist physicians in the interpretation of echinococcosis serology results.
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Affiliation(s)
- Moshe Shmueli
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Jacob Van Buren
- Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Orli Sagi
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- The Parasitology Laboratory, Soroka University Medical Center, Beer-Sheva, Israel
| | - Daniel Grupel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Internal Medicine B, Soroka University Medical Center, Beer Sheva, Israel
| | - Asaf Sheves
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Department of Pediatric Surgery, Soroka University Medical Center, Beer-Sheva, Israel
| | - Zaki Assi
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Internal Medicine B, Soroka University Medical Center, Beer Sheva, Israel
| | - Shalom Ben-Shimol
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel.
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12
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Li YP, Zhang J, Li ZD, Ma C, Tian GL, Meng Y, Chen X, Ma ZG. Diagnosis and treatment experience of atypical hepatic cystic echinococcosis type 1 at a tertiary center in China. World J Gastroenterol 2024; 30:462-470. [PMID: 38414590 PMCID: PMC10895592 DOI: 10.3748/wjg.v30.i5.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/19/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Some hydatid cysts of cystic echinococcosis type 1 (CE1) lack well-defined cyst walls or distinctive endocysts, making them difficult to differentiate from simple hepatic cysts. AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries. METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region (China) from January 2018 to September 2023 were retrospectively analyzed. Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis, routine abdominal ultrasound, high-frequency ultrasound, abdominal computed tomography (CT) scan, and laparoscopy. Subsequent to the treatments, these patients underwent reexaminations at the outpatient clinic until October 2023. The evaluations included the diagnostic precision of diverse examinations, the efficacy of surgical approaches, and the incidence of CE recurrence. RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan. Among them, 16 patients were preoperatively diagnosed with atypical CE1, and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound. All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy, of whom 14 patients were intraoperatively confirmed to have CE1, which was consistent with the postoperative pathological diagnosis, one patient was diagnosed with a mesothelial cyst of the liver, and the other was diagnosed with a hepatic cyst combined with local infection. Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts, 4 received aspiration sclerotherapy of hepatic cysts, and 19 received laparoscopic fenestration. These patients were intraoperatively diagnosed with simple hepatic cysts. During the follow-up period, none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices. One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space. CONCLUSION Abdominal high-frequency ultrasound can detect CE1 hydatid cysts. The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.
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Affiliation(s)
- Yu-Peng Li
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Jie Zhang
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Zhi-De Li
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Chao Ma
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Guang-Lei Tian
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Yuan Meng
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Xiong Chen
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
| | - Zhi-Gang Ma
- Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
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13
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Pichioni P, Kokkinovasilis D, Stylianou S, Kipouridis G, Al Mogrampi S. Primary Retroperitoneal Echinococcal Cyst Treated With a Total Cystectomy. Cureus 2024; 16:e53887. [PMID: 38465122 PMCID: PMC10925024 DOI: 10.7759/cureus.53887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Cystic echinococcosis is a zoonotic disease caused by Echinococcus granulosus and causes significant morbidity, especially in endemic areas. It may remain asymptomatic for a long period. The clinical presentation depends on the exertion of pressure on adjacent organs or the sudden rupture of formed cysts. The presence of primary retroperitoneal echinococcal cysts, with no other organ involvement, has been scarcely reported in the literature. The aim of this study is to present the case of a 69-year-old male complaining of right flank pain for a month. Abdominal CT and MRI were performed, both revealing a large retroperitoneal mass measuring 18 centimeters in diameter, with daughter cysts and spots of calcification. The enzyme-linked immunosorbent assay (ELISA) for hydatid was positive. The patient denied any prior history of hydatidosis; thus, the diagnosis of a primary retroperitoneal echinococcal cyst was established. The patient underwent a successful total cystectomy and is in follow-up, reporting no recurrence of symptoms. Although the presence of echinococcal cysts in locations other than the liver or the lungs is rare, clinicians should always consider the possibility of a hydatid cyst diagnosis and perform the required diagnostic tests.
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Affiliation(s)
- Polyxeni Pichioni
- Department of Surgery, General Hospital of Imathia, Naousa Health Unit, Naousa, GRC
| | | | - Stylianos Stylianou
- Department of Surgery, General Hospital of Imathia, Naousa Health Unit, Naousa, GRC
| | - Georgios Kipouridis
- Department of Surgery, General Hospital of Imathia, Naousa Health Unit, Naousa, GRC
| | - Saant Al Mogrampi
- Department of Surgery, General Hospital of Imathia, Naousa Health Unit, Naousa, GRC
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14
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Slavu IM, Gheorghita V, Macovei Oprescu AM, Filipoiu F, Munteanu O, Tulin R, Dogaru IA, Ursuț BM, Tulin A. Primary Retroperitoneal Hydatid Cyst: A Diagnostic and Treatment Conundrum. Cureus 2024; 16:e53842. [PMID: 38465152 PMCID: PMC10924441 DOI: 10.7759/cureus.53842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Hydatid cysts are caused by accidental egg ingestion of the Echinococcus granulosus parasite. A 24-year-old female was admitted to our hospital for chronic left lumbar pain. Computed tomography (CT) and abdominal ultrasonography identified an 8/12 cm retroperitoneal cyst. The CT results coupled with enzyme-linked immunosorbent assay tests (positive IgG for Echinococcus granulosus) confirmed that the tumor was a hydatid cyst. Treatment consisted of preoperative chemotherapy with albendazole, intraoperative parasite inactivation, laparoscopic partial cystectomy, and drainage. The drain was removed after three days. Chemotherapy was maintained for two years after surgery. No relapse was observed at the six-month reevaluation. In this article, the diagnostic and therapeutic options and resources are discussed and compared with the published literature.
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Affiliation(s)
- Iulian M Slavu
- Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Valeriu Gheorghita
- Infectious Disease, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
| | | | - Florin Filipoiu
- Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Octavian Munteanu
- Obstetrics and Gynaecology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Raluca Tulin
- Anatomy and Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- Endocrinology, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
| | - Iulian A Dogaru
- General Surgery, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
- Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Bogdan M Ursuț
- Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Adrian Tulin
- General Surgery, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU
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15
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Yan L, Chu Z, Yang J, Zhang Y, Liu G, Lei Z, Chen Q, Li J, Yang J, Zhao M, Zhang S, Wu X, Peng X, Zhang H. Multiple cystic echinococcosis in abdominal and pelvic cavity treated by surgery with a 4-year follow-up: a case report. Front Med (Lausanne) 2024; 11:1276850. [PMID: 38304097 PMCID: PMC10830638 DOI: 10.3389/fmed.2024.1276850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024] Open
Abstract
We report a case of a male patient who presented with multiple abdominal and pelvic echinococcosis. The patient had been diagnosed with hepatic echinococcosis for 7 years and developed intermittent distension and discomfort in the upper abdomen after an accidental fall. In recent years, the patient's abdominal distention increased gradually. Computed tomography revealed multiple hydatid cysts in the liver, spleen, abdominal cavity, and pelvic cavity. Abdominal organs were severely compressed, such that he could not eat normally except for a liquid diet. The patient underwent radical surgical resection based on the multi-disciplinary treatment (MDT) and the operation lasted 10 h, nearly 100 hydatid cysts were excised, about 18 liters of cyst fluid and cyst contents were removed, and the patient lost 20 kg of weight after surgery. The operation was successful, but there were still some postoperative complications such as hypovolemic shock, postoperative ascites, postoperative bile leakage. Treatment measures for the patient were anti-infection, antishock, clamping the abdominal drainage tube, and negative pressure abdominal puncture drainage. At follow up the patient's quality of life had been significantly improved with 15 kg weight gain compared to before.
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Affiliation(s)
- Lerong Yan
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
- School of Medicine of Shihezi University, Shihezi, China
| | - Zhiqiang Chu
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Jian Yang
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Yongguo Zhang
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Guisheng Liu
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Zhen Lei
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Qian Chen
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Jiang Li
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Jing Yang
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Meifeng Zhao
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Shijie Zhang
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
- NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Shihezi, China
- Xinjiang Production and Construction Corps Infectious Diseases Clinical Medical Research Center, Shihezi, China
| | - Xiangwei Wu
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
- NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Shihezi, China
- Xinjiang Production and Construction Corps Infectious Diseases Clinical Medical Research Center, Shihezi, China
| | - Xinyu Peng
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
- NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Shihezi, China
- Xinjiang Production and Construction Corps Infectious Diseases Clinical Medical Research Center, Shihezi, China
| | - Hongwei Zhang
- Department of Heaptobiliary Surgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
- NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Shihezi, China
- Xinjiang Production and Construction Corps Infectious Diseases Clinical Medical Research Center, Shihezi, China
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16
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Safai Zadeh E, Prosch H, Ba-Ssalamah A, Findeisen H, Alhyari A, Raab N, Görg C. Contrast-enhanced ultrasound of the liver: basics and interpretation of common focal lesions. ROFO-FORTSCHR RONTG 2024. [PMID: 38176437 DOI: 10.1055/a-2219-4726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Over the past 20 years, contrast-enhanced ultrasound (CEUS) has become established as a procedure that is complementary to B-mode ultrasound and color Doppler sonography.The aim of this review is to provide the fundamental knowledge required for examining the liver with CEUS. Additionally, the characteristic CEUS patterns of frequent focal liver lesions are described.Considering the limitations of ultrasound, CEUS offers an equivalent alternative to other imaging modalities, such as computed tomography and magnetic resonance imaging, for evaluating focal liver lesions. It should be utilized as a primary modality due to its lack of radiation exposure and rapid availability. KEY POINTS:: · CEUS plays an important role particularly in the detection and evaluation of incidentally detected liver lesions.. · Considering the limitations of ultrasound, CEUS offers an equivalent alternative to other imaging modalities, such as CT and MRI, for evaluating focal liver lesions.. CITATION FORMAT: · Safai Zadeh E, Prosch H, Ba-Ssalamah A et al. Contrast-enhanced ultrasound of the liver: basics and interpretation of common focal lesions. Fortschr Röntgenstr 2024; DOI: 10.1055/a-2219-4726.
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Affiliation(s)
- Ehsan Safai Zadeh
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Wien, Austria
| | - Helmut Prosch
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Wien, Austria
| | - Ahmed Ba-Ssalamah
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Wien, Austria
| | - Hajo Findeisen
- Department for Internal Medicine, Red Cross Hospital Bremen, Germany
| | - Amjad Alhyari
- Interdisciplinary Centre of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital of Gießen and Marburg Campus Marburg, Germany
| | - Nils Raab
- Department for Internal Medicine, West Mecklenburg Hospital Helene von Bülow, Ludwigslust, Germany
| | - Christian Görg
- Interdisciplinary Centre of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital of Gießen and Marburg Campus Marburg, Germany
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17
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Trigui A, Khmekhem N, Fendri S, Daoud R, Akrout A, Trabelsi J, Mzali R, Cheikhrouhou F, Ayadi A, Dziri C, Amar MB, Boujelbene S. Viability predictive factors of the daughter vesicles in hepatic cystic echinococcosis. BMC Infect Dis 2024; 24:43. [PMID: 38172702 PMCID: PMC10765707 DOI: 10.1186/s12879-023-08937-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Management of cystic echinococcosis (CE) requires knowledge of certain aspects related to the survival of Echinococcus granulosus. The viability of daughter vesicles (DV) is a determining factor in guiding therapeutic indications, particularly for transiently active Cysts type CE3b. PURPOSE To determine the predictive factors of DV viability and its impact on the therapeutic management of CE3b type. MATERIALS AND METHODS This is a prospective pilot study with an analytical aim on patients with cystic echinococcosis of the liver type CE2 and CE3b, operated in the General Surgery Department of Habib-Bourguiba Academic Hospital, Sfax-Tunisia for 22 months from March 2018 until December 2019. The unit of the study is the DV. A parasitological study of the DV was done in the parasitology laboratory. RESULTS During the study period, 27 (40.9%) of 66 operated CE Disease from 21 patients containing 248 DV were explored. The median viability of DV protoscoleces was 16.7%. In bivariate analysis, factors for viability of DV protoscoleces were: fever, acute cholangitis, hyperbilirubinemia, left liver location, rock water and bilious echinococcal fluid (EF), cyst size ≥ 43 mm, Intracystic pressure ≥ 35 mmHg, DV size ≥ 6.5 mm, volume, number of DV/cyst ≥ 5, and opaque wall (p < 0.05). Predictive factors for the Non-viability of DV were: CE3b type, purulent EF, gelatinous EF. In multivariate analysis, only CE2 type, cyst size ≥ 43 mm, number of DV/cyst ≥ 5 and DV size ≥ 6.5 mm were factors significantly associated with the viability of DV protoscoleces. CONCLUSION CE3b cysts without the criteria of viability of DV protoscoleces may become candidates for the 'Wait-and-Watch' procedure.
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Affiliation(s)
- Aymen Trigui
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia.
| | - Nahed Khmekhem
- Faculty of Medicine, Department of Parasitology and Mycology, University of Sfax, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Sami Fendri
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| | - Rahma Daoud
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| | - Amira Akrout
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| | - Jihene Trabelsi
- Faculty of Medicine, Department of Epidemiology, University of Sfax, Hedi Cheker Hospital, Sfax, Tunisia
| | - Rafik Mzali
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| | - Fatma Cheikhrouhou
- Faculty of Medicine, Department of Parasitology and Mycology, University of Sfax, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Ali Ayadi
- Faculty of Medicine, Department of Parasitology and Mycology, University of Sfax, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Chadli Dziri
- General Surgery, Honoris Medical Simulation Center Director, Medical school of Tunis, University El Manar, Tunis, Tunisia
| | - Mohamed Ben Amar
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| | - Saleh Boujelbene
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
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18
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Hasanzadeh A, Beiromvand M, Rafiei A, Kazemi M, Bahreini A, Khanahmad H. Expression of Matrix Metalloproteinases in Human Cystic Echinococcosis. Curr Mol Med 2024; 24:244-251. [PMID: 36617714 DOI: 10.2174/1566524023666230106163928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/13/2022] [Accepted: 11/22/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cystic echinococcosis (CE) is a zoonotic disease caused by the Echinococcus granulosus senso lato (E. granulosus s.l.) larval stages. Parasitederived products have been shown to regulate host matrix metalloproteinases (MMPs), contributing to CE pathogenesis and progressive liver fibrosis in intermediate hosts. The current study aimed to investigate the potential role of MMP1, 7, 8, and 13 in E. granulosus s.l-induced liver fibrosis. METHODS Thirty CE patients with active, transitional, or inactive hydatid cysts were enrolled in this study to determine the inductive effects of E. granulosus on the expression of MMP-1, MMP-7, MMP-8, and MMP-13 in healthy liver tissue and fibrotic liver tissue using qRT-PCR. RESULTS According to the WHO-IWGE classification, patients with functional cysts (CE1 and CE2) had the highest percentage (46.6%). MMP-1, MMP-7, MMP-8, and MMP-13 expression levels were significantly higher in fibrotic liver than in normal liver tissue. MMP-13 and MMP-1 had the highest and lowest expression levels among MMPs. Compared to the normal group, the fold change for MMP-13 in the fibrotic group was greater than 12 and had the highest AUC value (AUC= 0.8283). CONCLUSION Our findings suggest that E. granulosus-derived products might be involved in regulating host MMPs. Thus, MMPs may be considered potential biomarkers for predicting CE prognosis. Because of the non-normal distribution of our patients' CE types, further research, particularly on circulation MMPs, is needed to confirm the potential role of MMPs in CE pathogenesis and to follow up on CE patients.
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Affiliation(s)
- Azadeh Hasanzadeh
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Molouk Beiromvand
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abdollah Rafiei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Kazemi
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Bahreini
- Department of Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Khanahmad
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Di Giambenedetto S, Fagotti A, Quaranta G, Iannone V, Fancello G, Steiner RJ, Mazzon G, Masucci L, Teodorico E, Borghetti A, Naldini A, Scambia G. Reporting a single case of cystic echinococcosis in retroperitoneal mass of uncertain origin. Parasitol Res 2023; 123:40. [PMID: 38095718 DOI: 10.1007/s00436-023-08018-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023]
Abstract
Echinococcal disease (hydatid disease (HD) is an endemic parasitosis caused by Echinococcus granulosus in the larval stage, and it is typically due to the production of unilocular cystic lesions, usually involving the liver for the majority of patients and the lungs in 25%, but also any other organs can be potentially involved in developing echinococcal disease. We report a case of extrahepatic, retroperitoneal echinococcal disease, caused by Echinococcus granulosus. The patient underwent a surgical removal of the abdominal mass, revealed by abdominal ultrasound and computerized tomography scanning, and in the founded clinical and radiological suspicion of echinococcal disease, multiple bioptical samples were sent for microbiological analysis and albendazole therapy was started; Echinococcus granulosus protoscolices were found on the bioptical sample, and the diagnosis was successfully confirmed. According to the current parasitology literature on echinococcal disease, extrahepatic localization, although rare, can be found, and it should be considered in the differential diagnosis of an abdominal mass when epidemiological risk factors and anamnestic data are present, regardless of the usual site of the disease.
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Affiliation(s)
- Simona Di Giambenedetto
- Department of Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Security and Bioethics, Infectious Disease, Catholic University of Sacred Heart, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Anna Fagotti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo Agostino Gemelli 8, 00168, Rome, Italy
- Department of Woman, Child, and Public Health, UOC Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gianluca Quaranta
- Department of Laboratory and Infectious Sciences, A. Gemelli University Hospital IRCCS, 00168, Rome, Italy
| | - Valentina Iannone
- Department of Security and Bioethics, Infectious Disease, Catholic University of Sacred Heart, Rome, Italy.
| | - Giovanni Fancello
- Department of Laboratory and Infectious Sciences, A. Gemelli University Hospital IRCCS, 00168, Rome, Italy
| | - Rebecca Jo Steiner
- Department of Security and Bioethics, Infectious Disease, Catholic University of Sacred Heart, Rome, Italy
| | - Giovanni Mazzon
- Department of Diagnostic Imaging, Radiation Oncology and Hematology; UOC Radiology and Neuroradiology, Catholic University of Sacred Heart, Rome, Italy
| | - Luca Masucci
- Department of Basic Biotechnological Sciences, Intensivological and Perioperative Clinics, Catholic University of Sacred Heart, 00168, Rome, Italy
| | - Elena Teodorico
- Department of Security and Bioethics, Infectious Disease, Catholic University of Sacred Heart, Rome, Italy
| | - Alberto Borghetti
- Department of Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Security and Bioethics, Infectious Disease, Catholic University of Sacred Heart, Rome, Italy
| | - Angelica Naldini
- Department of Security and Bioethics, Infectious Disease, Catholic University of Sacred Heart, Rome, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Largo Agostino Gemelli 8, 00168, Rome, Italy
- Department of Woman, Child, and Public Health, UOC Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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THARWAT M, EL MOGHAZY HM, OIKAWA S. Ultrasonographic verification of hepatic hydatidosis in a female dromedary camel: a case report. J Vet Med Sci 2023; 85:1286-1290. [PMID: 37880080 PMCID: PMC10788162 DOI: 10.1292/jvms.23-0325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023] Open
Abstract
This report describes for the first time, the antemortem diagnosis of hydatidosis in dromedary camel based on the WHO informal working groups on echinococcosis guidelines of echinococcosis classification. The case was admitted at the University Veterinary Hospital, Qassim University, Saudi Arabia, with a history of progressive weight loss and decreased appetite for the past 4 months. Alterations in hematobiochemical parameters included leukopenia, neutropenia, decreased hematocrit percent, red blood cells count and hemoglobin concentration, hypoproteinemia, hypoalbuminemia, hyperglobulinemia, hyperglycemia and azotemia. Ultrasonographically, multiple cysts were imaged within the hepatic tissue containing anechoic fluid and fibrin tags. Ultrasound-guided aspiration of a cyst revealed a clear non-turbid fluid. Ultrasonographic diagnostic is recommended for the work-up of cystic lesions of camel liver suspected to be due to Echinococcus granulosus.
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Affiliation(s)
- Mohamed THARWAT
- Department of Veterinary Medicine, College of Agriculture
and Veterinary Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Hazem M EL MOGHAZY
- Veterinary Teaching Hospital, Faculty of Veterinary
Medicine, Benha University, Benha, Egypt
| | - Shin OIKAWA
- Department of Veterinary Herd Health, School of Veterinary
Medicine, Rakuno Gakuen University, Hokkaido, Japan
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21
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Yosra K, Ghada H, Bochra A, Fatma T, Said J, Riadh J. Predictive Factors of Liver Hydatid Cyst Recurrence in Children. J Pediatr Surg 2023; 58:2362-2367. [PMID: 37500372 DOI: 10.1016/j.jpedsurg.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Liver hydatid cyst affects approximately 95% of the world's echinococcosis cases. Despite advances in treatment, the recurrence rate remains high and is influenced by several factors that are yet to be determined. The objective of this study was to identify the predictive factors of liver hydatid cyst recurrence following surgery in children and to establish a treatment regimen aimed at preventing this postoperative morbidity. METHODS A bi-centric retrospective descriptive and analytic study was conducted involving 122 children who underwent surgery for liver hydatid cysts between January 1st, 2009, and December 31st, 2017. All factors that could potentially contribute to recurrence were thoroughly investigated. The data was processed using SPSS.v21, and a significant level of p-value 0.05 was applied. RESULTS Out of the 122 children, 20 patients experienced cyst recurrence (16.39%). Among them, there were nine girls and eleven boys. The median time of recurrence was 16.5 months. Abdominal ultrasonography demonstrated efficacy in detecting recurrence. Several factors were identified as predictors of postoperative recurrence, including intimate contact of the hydatid cyst with the large vessels (p = 0.031), intraperitoneal effusion (p = 0.042), bile duct dilation (p = 0.032), and postoperative spontaneous discontinuation of medical treatment (p = 0.010). Among these factors, two independent risk factors for recurrence were identified: intimate contact of the hydatid cyst with the large vessels (p = 0.011) and the presence of an intraperitoneal effusion (p = 0.018). CONCLUSION Our study has identified several predictors of postoperative recurrence, including two previously undocumented risk factors in the literature. Awareness of these risk factors can assist surgeons in implementing preventive measures to avoid the recurrence of hydatid cysts. LEVEL OF EVIDENCE Prognosis study Level II.
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Affiliation(s)
- Kerkeni Yosra
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia.
| | - Habachi Ghada
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Aziza Bochra
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Thamri Fatma
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Jlidi Said
- Department of Pediatric Surgery "B", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
| | - Jouini Riadh
- Department of Pediatric Surgery "A", Children's Hospital, Tunis El Manar University, Tunis, Tunisia
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22
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Wang H, Yu Q, Wang M, Hou J, Wang M, Kang X, Hou X, Li D, Rousu Z, Jiang T, Li J, Wen H, Zhang C. Hepatic macrophages play critical roles in the establishment and growth of hydatid cysts in the liver during Echinococcus granulosus sensu stricto infection. PLoS Negl Trop Dis 2023; 17:e0011746. [PMID: 37930989 PMCID: PMC10653610 DOI: 10.1371/journal.pntd.0011746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/16/2023] [Accepted: 10/21/2023] [Indexed: 11/08/2023] Open
Abstract
Cystic echinococcosis (CE) is a worldwide neglected zoonotic disease caused by infection with the larval stage of the tapeworm Echinococcus granulosus sensu lato (E. granulosus s.l.), which predominantly resides in the liver accompanied by mild inflammation. Macrophages constitute the main cellular component of the liver and play a central role in controlling the progression of inflammation and liver fibrosis. However, the role of hepatic macrophages in the establishment and growth of hydatid cysts in the liver during E. granulosus sensu stricto (E. granulosus s.s.) infection has not been fully elucidated. Here, we showed that CD68+ macrophages accumulated in pericystic areas of the liver and that the expression of CD163, a marker of anti-inflammatory macrophages, was more evident in active CE patients than in inactive CE patients. Moreover, in a mouse model of E. granulosus s.s. infection, the pool of hepatic macrophages expanded dramatically through the attraction of massive amounts of monocyte-derived macrophages (MoMFs) to the infection site. These infiltrating macrophages preferentially polarized toward an iNOS+ proinflammatory phenotype at the early stage and then toward a CD206+ anti-inflammatory phenotype at the late stage. Notably, the resident Kupffer cells (KCs) predominantly maintained an anti-inflammatory phenotype to favor persistent E. granulosus s.s. infection. In addition, depletion of hepatic macrophages promoted E. granulosus s.s. larval establishment and growth partially by inhibiting CD4+ T-cell recruitment and liver fibrosis. The above findings demonstrated that hepatic macrophages play a vital role in the progression of CE, contributing to a better understanding of the local inflammatory responses surrounding hydatid cysts and possibly facilitating the design of novel therapeutic approaches for CE.
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Affiliation(s)
- Hui Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Echinococcosis, Clinical Medicine Institute, World Health Organization Collaborating Centre on Prevention and Case Management of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qian Yu
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Mingkun Wang
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Jiao Hou
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Maolin Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Department of Hepatic Hydatid and Hepatobiliary Surgery, Digestive and Vascular Surgery Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xuejiao Kang
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xinling Hou
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Dewei Li
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zibigu Rousu
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Tiemin Jiang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Department of Hepatic Hydatid and Hepatobiliary Surgery, Digestive and Vascular Surgery Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Jing Li
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hao Wen
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Echinococcosis, Clinical Medicine Institute, World Health Organization Collaborating Centre on Prevention and Case Management of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Chuanshan Zhang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Echinococcosis, Clinical Medicine Institute, World Health Organization Collaborating Centre on Prevention and Case Management of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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Safarpour MM, Aminnia S, Dehghanian A, Borazjani R, Abbassi HR, Boland Parvaz S, Paydar S. Primary hydatid cyst of the thyroid glands: two case reports and a review of the literature. J Med Case Rep 2023; 17:417. [PMID: 37789467 PMCID: PMC10548661 DOI: 10.1186/s13256-023-04141-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/24/2023] [Indexed: 10/05/2023] Open
Abstract
INTRODUCTION Although hydatid cyst remains one of the prevalent parasitic infections in humans, hydatid cyst of the thyroid is extremely rare, even in endemic areas. Here we present two cases of thyroid hydatid cysts. CASE PRESENTATION A 35 and a 50 year-old Iranian female with a positive history of animal contact were presented with a neck lump without any compressive symptoms. A physical exam revealed neck masses that elevated with swallowing. Thyroid gland ultrasonography showed cystic thyroid lesions, and fine needle aspiration (FNA) suggested a thyroid hydatic cyst. Thyroid lobectomy and isthmectomy were done for the first patient, and near-total thyroidectomy was done for the other. The pathology report confirmed the diagnosis of a hydatid cyst. None of the patients had hydatid cysts in other sites. Patients were discharged without an antiparasitic drug, and no recurrence was detected at the six-month follow-up. CONCLUSION It is necessary to consider hydatid cysts in the differential diagnosis of cystic lesions of the thyroid gland in endemic areas, especially in people with a positive history of animal contact.
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Affiliation(s)
| | - Shiva Aminnia
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Amirreza Dehghanian
- Molecular Pathology and Cytogenetics Division, Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roham Borazjani
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
- Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Reza Abbassi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Boland Parvaz
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Paydar
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Akhan O. Percutaneous treatment of liver hydatid cysts: to PAIR or not to PAIR. Curr Opin Infect Dis 2023; 36:308-317. [PMID: 37548385 DOI: 10.1097/qco.0000000000000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PURPOSE OF REVIEW The aim is to review recent literature for percutaneous treatment of liver hydatid cysts (cystic echinococcosis: CE) via different techniques such as PAIR (puncture, aspiration, injection, and reaspiration), standard catheterization, and modified catheterization technique (MoCaT). RECENT FINDINGS PAIR is an established technique and considered to be safe and effective for CE1 and CE3a as it is associated with lower morbidity, mortality, recurrence, and shorter hospital stay as compared with surgery. Standard catheterization is also dedicated for the treatment of CE1 and CE3a. PAIR should be preferred for treatment of liver CE1 and CE3a cysts, since PAIR is associated with lower major complication rates and shorter hospital stay. However, standard catheterization technique is indicated when cysto-biliary fistula develops or any technical difficulty arises during the PAIR. In these cases it is needed to switch PAIR to standard catheterization to complete the procedure. SUMMARY For CE1 and CE3a cysts, PAIR and standard catheterization are the choice for percutaneous treatments, while MoCaT is a treatment option for CE2 and CE3b cysts.
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Affiliation(s)
- Okan Akhan
- Department of Radiology, Faculty of Medicine, Hacettepe University, Sihhiye, Ankara, Turkey
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25
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Monge-Maillo B, Lopez-Velez R. Cystic echinococcosis of the bone. Curr Opin Infect Dis 2023; 36:341-347. [PMID: 37593962 DOI: 10.1097/qco.0000000000000951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
PURPOSE OF REVIEW Cystic echinococcosis (CE) has a wide world distribution causing important morbidity. Osseous involvement is present in less than 4% of the CE cases. Its diagnosis and therapeutic management is full of challenges and low grade of evidence. RECENT FINDINGS The study summarizes literature evidence on the management of osseous CE with particular emphasis on new data regarding diagnosis and treatment. SUMMARY Clinical presentation of osseous CE depends on the skeletal area affected. Diagnosis is mostly based on radiological findings and serology. Recent advances with qPCR on osseous tissue samples seem to be a good option for diagnosis confirmation. Complete resection of the cystic lesion is the only curative option, but it is usually not possible performing palliative surgery and prolonged albendazole intake in most cases. Radiotherapy could be an option, but experience to date is only based on clinical cases.
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Affiliation(s)
- Begoña Monge-Maillo
- National Reference Unit for Tropical Diseases. Infectious Diseases Department, Ramón y Cajal University Hospital. IRICYS. CIBERINFEC. Madrid, Spain
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26
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Kalogeropoulu SK, Schwierz E, Meyerhoff M, Ratjszczak R, Nadler T, Raphael BL. ULTRASOUND-GUIDED PERCUTANEOUS TREATMENT OF HEPATIC HYDATIDOSIS IN TWO RED-SHANKED DOUC LANGURS ( PYGATHRIX NEMAEUS). J Zoo Wildl Med 2023; 54:645-650. [PMID: 37817632 DOI: 10.1638/2022-0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 10/12/2023] Open
Abstract
Hydatid disease caused by Echinococcus ortleppi is a major cause of morbidity and mortality for critically endangered captive langurs in northern Vietnam. The most common sites for hydatid cyst development are the liver and the lungs. Chemotherapy trials with albendazole alone or in combination with praziquantel in these langurs had varying results and in most cases were ineffective. Ultrasound-guided percutaneous aspiration of cystic fluid followed by instillation and re-aspiration of a scolicidal agent (PAIR technique), has gained importance in the treatment of active hepatic cysts in humans and in many cases is preferred over surgical and endoscopic approaches. The PAIR technique was used in two red-shanked douc langurs (Pygathrix nemaeus) for the treatment of unilocular active hepatic cysts. The technique was found to be fairly easy to perform, safe, and effective and should be a useful treatment tool for hepatic hydatidosis in langurs and other nonhuman primate species.
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Affiliation(s)
- Szilvia K Kalogeropoulu
- Department of Interdisciplinary Life Sciences, Research Institute of Wildlife Ecology, University of Veterinary Medicine, Vienna, A-1160, Austria,
| | - Elke Schwierz
- Endangered Primate Rescue Center, Cuc Phuong National Park, Cuc Phuong, 43000, Ninh Binh, Vietnam
| | | | - Radoslaw Ratjszczak
- Endangered Primate Rescue Center, Cuc Phuong National Park, Cuc Phuong, 43000, Ninh Binh, Vietnam
| | - Tilo Nadler
- Three Monkeys Wildlife Conservancy, Cuc Phuong Village, 43000, Ninh Binh, Vietnam
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27
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Berto CG, Liou P, Coyle CM, Emond JC. Surgical management of cystic echinococcosis of the liver. Curr Opin Infect Dis 2023; 36:348-352. [PMID: 37548389 DOI: 10.1097/qco.0000000000000955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PURPOSE OF REVIEW Cystic echinococcosis is a zoonotic infection frequently involving the liver. Treatment options, including surgery, are decided based on the staging of the disease. RECENT FINDINGS Ultrasound is the cornerstone for diagnosis, staging, and follow-up of cystic echinococcosis. MRI can help to evaluate for cystobiliary complications and planning of the surgery. The two main surgical approaches for cystic echinococcosis include a radical approach, which entails a partial hepatectomy and total pericystectomy, and a conservative approach or endocystectomy. Recent data suggest a conservative approach is well tolerated with acceptable morbidity and no mortality. Recurrences in centers with experience are rare. Data on laparoscopic surgery is emerging, but long-term follow-up still needs to be improved. SUMMARY Surgical treatment options should be carefully evaluated according to the cystic echinococcosis disease staging. A multidisciplinary approach, including diagnostic and interventional radiology, abdominal and liver surgery, and infectious diseases, results in better outcomes.
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Affiliation(s)
- Cesar G Berto
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Peter Liou
- Liver and Abdominal Transplant Surgery, Columbia University Irving Medical Center, New York
| | - Christina M Coyle
- Division of Infectious Disease, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Jean C Emond
- Liver and Abdominal Transplant Surgery, Columbia University Irving Medical Center, New York
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28
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Popova G, Vuchev D, Anichina K. Treatment of hepatic and pulmonary hydatidosis with albendazole and praziquantel. Helminthologia 2023; 60:221-226. [PMID: 38152469 PMCID: PMC10750241 DOI: 10.2478/helm-2023-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/27/2023] [Indexed: 12/29/2023] Open
Abstract
Conservative treatment of human hydatidosis (cystic echinococcosis) with albendazole has improved significantly the prognosis of the disease. But its therapeutic effectiveness is 30 - 70 %. There is some evidence that the effectiveness of albendazole can be enhanced by praziquantel but there is no strict recommendation for the use of praziquantel as part of long-term drug therapy for hydatidosis. The aim of the study was to evaluate the effectiveness of the combination of albendazole and praziquantel in patients with hepatic and/or pulmonary hydatidosis. A total of 20 patients (aged 12 - 70 years old) were included in the study for a 5-year period. Fourteen patients (70 %) were with hepatic hydatidosis, 4 (20 %) with pulmonary and 2 (10 %) with hepatic and pulmonary hydatidosis. They were treated with albendazole (15 mg/kg/day) and praziquantel (40 mg/kg/weekly) for 2 - 9 one-month courses. The result of the therapy was followed using imaging (abdominal ultrasound, lung radiography, computed tomography) and serology. Seventeen (85 %) out of 20 patients showed evidence of response on imaging defined as improvement or cure of hydatid cysts. Seven (35 %) of the patients with multiple cystic echinococcosis took praziquantel once a week for 6 months. Only 3 patients (15 %) with multiple hydatidosis (2 with liver and 1 with pulmonary hydatidosis) failed to respond to the therapy with both drugs. No side effects have been reported by the patients. The combination of albendazole and praziquantel seems to be an option to improve the therapeutic effectiveness of the conservative treatment of cystic echinococcosis.
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Affiliation(s)
- G. Popova
- Medical University of Plovdiv, Department of Infectious diseases, Parasitology and Tropical Medicine, Section of Parasitology, St. George University Hospital, Plovdiv, Bulgaria
| | - D. Vuchev
- Medical University of Plovdiv, Department of Infectious diseases, Parasitology and Tropical Medicine, Section of Parasitology, St. George University Hospital, Plovdiv, Bulgaria
| | - K. Anichina
- University of Chemical Technology and Metallurgy, Sofia, Bulgaria
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Kaya V, Tahtabasi M, Konukoglu O, Yalcin M. Percutaneous Treatment of Giant Hydatid Cysts and Cystobiliary Fistula Management. Acad Radiol 2023; 30 Suppl 1:S132-S142. [PMID: 37120402 DOI: 10.1016/j.acra.2023.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 05/01/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate the efficacy and safety of percutaneous treatment in cystic echinococcosis (CE) type 1 and 3a giant cysts (with at least one diameter>10 cm) according to the World Health Organization classification and to evaluate the management of complications, especially cystobiliary fistulas (CBFs). MATERIALS AND METHODS This retrospective study included 66 patients with 68 CE1 and CE3a giant cysts treated with percutaneous catheterization between January 2016 and December 2021. The characteristics of the cysts, major and minor complications, time to catheter removal, and length of hospital stay were recorded. RESULTS Among the 68 cysts, CBFs occurred in 35 (51.5%), cavity infections in 11 (16.1%), recollection in five (7.4%), and anaphylaxis in three (4.5%). There was no mortality. Biliary drainage was observed intraoperatively in 20 (29.4%) and only postoperatively in 15 (22.1%) of the 35 cysts with CBFs. A plastic biliary stent was placed in 18 (51.5%) of the 35 cysts with CBFs. The patients with CBFs had a longer hospital stay and time to catheter removal than those without fistulas (15.3 ± 10.9 vs. 6.1 ± 2.6 days and 32.7 ± 51.8 vs. 6.2 ± 3.1 days, respectively; P < 0.001). Of the patients who developed recollection, three were treated with secondary catheterization, and two underwent surgery. In total, three patients underwent surgery. The rate of clinical success was 95.4%. All cysts were followed up for an average of 19.1 (range, 12-60) months, and there was an average 88.8% reduction in cyst volume compared to the initial evaluation. CONCLUSION CE1 and CE3a giant cysts can be treated effectively and safely with high clinical success using the catheterization technique. Contrary to what has previously been reported for these patients, the rate of CBFs is high, but these patients can successfully be treated with percutaneous drainage and/or endoscopic retrograde cholangiopancreatography without the requirement of surgery.
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Affiliation(s)
- Veysel Kaya
- Department of Radiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey (V.K.).
| | - Mehmet Tahtabasi
- Department of Radiology, Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey (M.T., O.K.).
| | - Osman Konukoglu
- Department of Radiology, Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey (M.T., O.K.).
| | - Metin Yalcin
- Department of General Surgery, Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey (M.Y.).
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Xiao S, Fu Q, Miao Y, Zhao M, Lu S, Xu J, Zhao W. Clinical efficacy and drug resistance of ceftazidime-avibactam in the treatment of Carbapenem-resistant gram-negative bacilli infection. Front Microbiol 2023; 14:1198926. [PMID: 37664109 PMCID: PMC10469675 DOI: 10.3389/fmicb.2023.1198926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/17/2023] [Indexed: 09/05/2023] Open
Abstract
Objective To examine the clinical efficacy, safety, and resistance of Ceftazidime-Avibactam (CAZ-AVI) in patients with Carbapenem-resistant Gram-negative bacilli (CR-GNB) infections. Methods We retrospectively analyzed relevant data of CR-GNB infected patients receiving CAZ-AVI treatment, analyzed relevant factors affecting drug efficacy, and compared the efficacy and safety with patients receiving Polymyxin B treatment. Results A total of 139 patients were included. Agranulocytosis, septic shock, SOFA score, and CAZ-AVI treatment course were independent risk factors affecting the prognosis of patients with CR-GNB infection treated with CAZ-AVI while prolonging the treatment course of CAZ-AVI was the only protective factor for bacterial clearance. The fundamental indicators showed no statistically significant differences between CAZ-AVI and Polymyxin B treatment groups. At the same time, the proportion of patients treated with monotherapy was significantly higher in the CAZ-AVI group than in the Polymyxin B group (37.2% vs. 8.9%, p < 0.05), the 30-day mortality rate of the CAZ-AVI treatment group (27.7% vs. 46.7%, p = 0.027) was lower than that of the Polymyxin B treatment group. The 30-day clinical cure rate (59.6% vs. 40% p = 0.030) and 14-day microbiological clearance rate (42.6% vs. 24.4%, p = 0.038) were significantly higher in the CAZ-AVI than in the Polymyxin B treatment group. Eighty nine patients were monitored for CAZ-AVI resistance, and the total resistance rate was 14.6% (13/89). The resistance rates of Carbapenem-resistant Klebsiella pneumoniae (CRKP) and Carbapenem-resistant Pseudomonas aeruginosa (CRPA) to CAZ-AVI were 13.5 and 15.4%, respectively. Conclusion CAZ-AVI has shown high clinical efficacy and bacterial clearance in treating CR-GNB infections. Compared with Polymyxin B, CAZ-AVI significantly improved the outcome of mechanical ventilation in patients with septic shock, agranulocytosis, Intensive Care Unit (ICU) patients, bloodstream infection, and patients with SOFA score > 6, and had a lower incidence of adverse events. We monitored the emergence of CAZ-AVI resistance and should strengthen the monitoring of drug susceptibility in clinical practice and the rational selection of antibiotic regimens to delay the onset of resistance.
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Affiliation(s)
- Shuang Xiao
- Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qianwen Fu
- Department of Critical Care Medicine, The First People's Hospital of Tonglu, Hangzhou, China
| | - Youhan Miao
- Department of Infectious Diseases, The Third Affiliated Hospital of Nantong University, Nantong, China
| | - Manna Zhao
- Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shengwei Lu
- Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Xu
- Center of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Weifeng Zhao
- Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
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Santucciu C, Ferrari PA, Grimaldi G, Murenu A, Nemolato S, Bonelli P, Masala G, Porcu GS, Cherchi R. Environmental Influence on the Occurrence of Multi-Organ Cystic Echinococcosis Infection in a Patient from Sardinia, Italy. Diseases 2023; 11:90. [PMID: 37489442 PMCID: PMC10366914 DOI: 10.3390/diseases11030090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/26/2023] Open
Abstract
An uncommon clinical case of an adult woman who was referred to the hospital with severe symptoms attributable to cystic echinococcosis (CE) is described in this report. According to a questionnaire, the subject was exposed to a high risk of infection since she was employed on a farm about 20 years before diagnosis. She lived close to several animal species and handled vegetables in inadequate hygienic conditions. Medical and laboratory investigations confirmed the presence of massive echinococcal cystic lesions in each lung and in the liver. Given the peculiarity of the case, pharmacological and surgical treatments were the only conceivable option. The association of pharmacological treatment, surgery, and interventional radiology procedure represented a reliable and effective way to handle a complex case of human hydatidosis. A multi-disciplinary approach was mandatory, resulting in a clear and conclusive diagnosis of CE caused by the zoonotic parasite E. granulosus sensu stricto of the G1 genotype.
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Affiliation(s)
- Cinzia Santucciu
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Paolo Albino Ferrari
- Division of Thoracic Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
| | - Giulia Grimaldi
- Division of Thoracic Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
| | - Alessandro Murenu
- Division of Thoracic Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
| | - Sonia Nemolato
- Department of Pathology, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
| | - Piero Bonelli
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Giovanna Masala
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Giuseppe Salvatore Porcu
- Department of Pathology, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
| | - Roberto Cherchi
- Division of Thoracic Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", 09121 Cagliari, Italy
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Teimouri A, Jafarpour Azami S, Hashemi Hafshejani S, Ghanimatdan M, Bahreini MS, Alimi R, Sadjjadi SM. Protoscolicidal effects of curcumin nanoemulsion against protoscoleces of Echinococcus granulosus. BMC Complement Med Ther 2023; 23:124. [PMID: 37072845 PMCID: PMC10111725 DOI: 10.1186/s12906-023-03927-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/17/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND The aim of the present study was to assess in vitro protoscolicidal effects of curcumin nanoemulsion (CUR-NE) against protoscoleces of cystic echinococcosis (CE)/hydatid cysts. METHODS The CUR-NE was prepared via spontaneous emulsification of soybean as the oil phase, a mixture of Tween 80 and Tween 85 as the surfactant, ethanol as the co-surfactant and distilled water. Various concentrations of CUR-NE (156, 312, 625 and 1250 µg/ml) were exposed to collected protoscoleces of infected sheep liver hydatid cysts for 10, 20, 30, 60 and 120 min. Viability of the protoscoleces were assessed using eosin exclusion test. Morphological changes of the protoscoleces were observed using differential interference contrast (DIC) microscopy. RESULTS The mean particle size and zeta potential of CUR-NE included 60.4 ± 14.8 nm and - 16.1 ± 1.1 mV, respectively. Results showed that the viability of the protoscoleces decreased significantly with increases in CUR-NE concentrations (p < 0.001). The mortality rates of protoscoleces with exposure to concentrations of 1250 and 625 µg/ml of CUR-NE for 60 min were 94 and 73.33%, respectively. Mortality of the protoscoleces was 100% after 120 min of exposure to 1250 and 625 µg/ml concentrations of CUR-NE. Using NIC microscopy, extensively altered tegumental surface protoscoleces was observed after protoscoleces exposure to CUR-NE. CONCLUSION The findings of the present study revealed the in vitro protoscolicidal potential of CUR-NE. Therefore, CUR-NEs are addressed as novel protoscolicidal agents, which can be used as an alternative natural medicine to kill the protoscoleces, owing to their low toxicity and significant inhibition potency. However, further studies are necessary to investigate pharmacologic and pharmacokinetics of CUR-NEs.
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Affiliation(s)
- Aref Teimouri
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sanaz Jafarpour Azami
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Hashemi Hafshejani
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ghanimatdan
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Saleh Bahreini
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rasoul Alimi
- Department of Epidemiology and Biostatistics, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Seyed Mahmoud Sadjjadi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Zhang X, Suolang L, Ren Y, Wang Y, Jiang Y, Zhong X, Gou Z, Zhou W, Chen J, Li Y, Cai D. Can contrast-enhanced ultrasound differentiate the type of hepatic echinococcosis: cystic echinococcosis or alveolar echinococcosis? Parasit Vectors 2023; 16:131. [PMID: 37069610 PMCID: PMC10111660 DOI: 10.1186/s13071-023-05731-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/11/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Hepatic echinococcosis (HE) is a zoonotic disease caused by Echinococcus, and Echinococcus granulosus and E. multilocularis are the most common, causing cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. Contrast-enhanced ultrasound (CEUS) is an imaging technique which has been recommended for identifying focal lesions in the liver. However, the effect of CEUS on the differentiation of hepatic echinococcosis type remains unclear. METHODS Twenty-five patients with 46 HE lesions confirmed by histopathology in our hospital from December 2019 to May 2022 were reviewed by conventional ultrasound (US) and CEUS examinations, respectively. After US was completed, the CEUS study was performed. A bolus injection of 1.0-1.2 ml of a sulfur hexafluoride-filled microbubble contrast agent (SonoVue®) was administered. The images and clips of the lesions by US and CEUS were reviewed retrospectively. The lesions detected using US were evaluated including the location, size, morphology, margin, internal echogenicity and the internal Doppler signal. The lesions detected using CEUS were evaluated including the enhancement degree, enhancement pattern and enhancing boundary in different phases. The diagnoses of lesions by US or CEUS were respectively recorded. By taking the histopathology as the gold standard, the paired Chi-square test was performed with statistical software (IBM SPSS; IBM Corp., Armonk, NY, USA), and the results of differentiation of HE type by US and CEUS were statistically analyzed. RESULTS A total of 46 lesions were involved in 25 patients, including 10 males (40.0%) and 15 females (60.0%) aged 15-55 (42.9 ± 10.3) years. By histopathology, 24 lesions of nine patients were diagnosed as CE and 22 lesions of 16 patients were diagnosed as AE. Among the 46 HE lesions, compared with histopathological examination, the accuracy rate was 65.2% and 91.3% in US and CEUS findings, respectively. Among the 24 CE lesions, 13 lesions were correctly differentiated by US, and 23 by CEUS. The difference between US and CEUS was statistically significant (Chi-square test, [Formula: see text] = 8.10, df = 23, P < 0.005). Among the total 46 HE lesions, 30 lesions were correctly differentiated by US, and 42 by CEUS. The difference between US and CEUS was statistically significant (Chi-square test, [Formula: see text] = 10.08, df = 45, P < 0.005). CONCLUSIONS CEUS is a more effective technique than US for differentiating the type of HE between CE and AE. It could be a reliable tool in the differentiation of HE.
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Affiliation(s)
- Xuhui Zhang
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Lamu Suolang
- Center of Disease Control and Prevention, Tibet Autonomous Region, Lhasa, 850002, China
| | - Yelei Ren
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yifei Wang
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yong Jiang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaofei Zhong
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Zehui Gou
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wu Zhou
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Juan Chen
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yongzhong Li
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Diming Cai
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Bai Z, Ma X, Yan R, Lei W, Zhang Y, Ren Y, Liu S. Metabolomic profiling of early inactive hepatic alveolar and cystic echinococcosis. Acta Trop 2023; 242:106875. [PMID: 36940858 DOI: 10.1016/j.actatropica.2023.106875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/24/2023] [Accepted: 02/27/2023] [Indexed: 03/23/2023]
Abstract
Hepatic alveolar echinococcosis (AE) and cystic echinococcosis (CE) are severe helminthic zoonoses and leading causes of parasitic liver damage. They pose a high mortality risk due to invisible clinical signs, especially at the early inactive stage. However, the specific metabolic profiles induced by inactive AE and CE lesions remain largely unclear. Therefore, we used gas chromatography-mass spectrometry-based metabolomic profiling to identify the global metabolic variations in AE and CE patient sera to differentiate between the two diseases and reveal the mechanisms underlying their pathogenesis. In addition, specific serum biomarkers of inactive hepatic AE and CE were screened using receiver operating curves, which can contribute to the clinical diagnosis of both diseases, especially in the earlier phase. These differential metabolites are involved in glycine, serine, tyrosine, and phenylalanine metabolism. Further analysis of key metabolic pathways showed that inactive AE lesions strongly alter amino acid metabolism in the host. CE lesions have an altered metabolism of oxidative stress response. These changes suggest these metabolite-associated pathways can serve as biomarkers to distinguish individuals with inactive AE and CE from healthy populations. This study also investigated the differences in serum metabolic profiles in patients with CE and AE. The biomarkers identified belonged to different metabolic pathways, including lipid, carnitine, androgen, and bile acid metabolism. Taken together, by investigating the different phenotypes of CE and AE with metabolomic profiling, serum biomarkers facilitating early diagnosis were identified.
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Affiliation(s)
- Zhenzhong Bai
- Research Center for High-Altitude Medicine, Medical College, Qinghai University, Xining, Qinghai, China 810001
| | - Xiao Ma
- Department of Hydatid Disease Prevention and Control, Qinghai Institute for Endemic Disease Prevention and Control, Xining, Qinghai, China, 810001
| | - Ranran Yan
- Research Center for High-Altitude Medicine, Medical College, Qinghai University, Xining, Qinghai, China 810001
| | - Wen Lei
- Department of Hydatid Disease Prevention and Control, Qinghai Institute for Endemic Disease Prevention and Control, Xining, Qinghai, China, 810001
| | - Yifan Zhang
- Department of Medical Imaging PET-CT Center, Qinghai Provincial People's Hospital, Xining, Qinghai, China, 810001
| | - Yanming Ren
- Research Center for High-Altitude Medicine, Medical College, Qinghai University, Xining, Qinghai, China 810001.
| | - Shou Liu
- Research Center for High-Altitude Medicine, Medical College, Qinghai University, Xining, Qinghai, China 810001; Department of Public Health, Plateau Medical Research Center, Medical College, Qinghai University, Xining, Qinghai, China, 810001.
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35
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Alshoabi SA, Alkalady AH, Almas KM, Magram AO, Algaberi AK, Alareqi AA, Hamid AM, Alhazmi FH, Qurashi AA, Abdulaal OM, Aloufi KM, Alsharif WM, Alsultan KD, Omer AM, Gareeballah A. The Neoplasms Mimicker: A Pictorial Review of Hydatid Disease. Diagnostics (Basel) 2023; 13:diagnostics13061127. [PMID: 36980435 PMCID: PMC10047450 DOI: 10.3390/diagnostics13061127] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Hydatid cyst is a common name for the larval stage of a tapeworm species of the genus Echinococcus granulosus, which is transmitted from animals to humans via the fecal–oral route. Hydatid cysts predominantly affect the liver (75%), followed by the lung (15%), and they can affect many organs in the human body. Medical imaging modalities are the keystone for the diagnosis of hydatid cysts with high sensitivity and specificity. Ultrasound imaging with high resolution is the first choice for diagnosis, differential diagnosis, staging, establishing a role in interventional management, and follow-up, and it can differentiate Type I hydatid cysts from simple liver cysts. Unenhanced computed tomography (CT) is indicated where or when an ultrasound is unsatisfactory, such as with chest or brain hydatid cysts, when detecting calcification, and in obese patients. Magnetic resonance imaging (MRI) is superior for demonstrating cyst wall defects, biliary communication, neural involvement, and differentiating hydatid cysts from simple cysts using diffusion-weighted imaging (DWI) sequences. According to the phase of growth, hydatid cysts occur in different sizes and shapes, which may mimic benign or malignant neoplasms and may create diagnostic challenges in some cases. Hydatid cysts can mimic simple cysts, choledochal cysts, Caroli’s disease, or mesenchymal hamartomas of the liver. They can mimic lung cystic lesions, mycetoma, blood clots, Rasmussen aneurysms, and even lung carcinomas. Differential diagnosis can be difficult for arachnoid cysts, porencephalic cysts, pyogenic abscesses, and even cystic tumors of the brain, and can create diagnostic dilemmas in the musculoskeletal system.
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Affiliation(s)
- Sultan Abdulwadoud Alshoabi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
- Correspondence:
| | | | | | | | | | - Amal A. Alareqi
- Radiology Department, 21 September University of Medical and Applied Science, Sana’a, Yemen
| | | | - Fahad H. Alhazmi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Abdulaziz A. Qurashi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Osamah M. Abdulaal
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Khalid M. Aloufi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Walaa M. Alsharif
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Kamal D. Alsultan
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Awatif M. Omer
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Awadia Gareeballah
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
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Gul Y, Muezzinoglu T, Kilicarslan G, Dogan S, Tuncer T. Application of the deep transfer learning framework for hydatid cyst classification using CT images. Soft comput 2023. [DOI: 10.1007/s00500-023-07945-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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Yoo JS, Kang MK, Park JG, Kim HJ, Choi JH. Clinical Implications for the Comprehensive Interpretation of Radiologic and Immunodiagnostic Tests in Patients Suspected of Parasitic Hepatic Cyst, a Rare Case in Korea. Trop Med Infect Dis 2023; 8:tropicalmed8030155. [PMID: 36977156 PMCID: PMC10052134 DOI: 10.3390/tropicalmed8030155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/06/2023] Open
Abstract
Cystic echinococcosis (CE) is a representative neglected tropical disease (NTD) with increased morbidity and mortality but is ignored and overlooked in developed countries. Serological and radiographic findings are helpful in distinguishing these parasites; however, conflicting results of these can make it difficult to diagnose if medical knowledge of hepatic parasitic disease, including the etiology, features of imaging, and immunodiagnostic test, is not acquired. We report the case of a male patient with dyspepsia and right epigastric pain who had positive results for cysticercosis antibodies on immunodiagnostic examination. Abdominal ultrasonography revealed two huge communicating cystic lesions measuring 8–11 cm. Further evaluations for cysticercosis of the brain (neurocysticercosis) and eyes (intraocular cysticercosis) were unremarkable throughout the brain imaging test and fundus examination. A laparoscopic right hemi-hepatectomy was performed for diagnosis and treatment. On histopathological examination, diverse stages of Echinococcus granulosus were identified. Albendazole was administered postoperatively, and the patient was also followed up. We should be aware of the etiologies that have been prevalent in parasite infection thought to be the cause of hepatic cysts. Moreover, we make an effort to ascertain the patient’s nationality, past travel experiences, and immediate environment, including any animals and pets. We present the case of a patient who was worried about the possibility of liver invasion of cysticercus due to the positivity of the cysticercosis antibody and was ultimately diagnosed with CE.
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Affiliation(s)
- Jae-Sung Yoo
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu 42415, Republic of Korea
| | - Min-Kyu Kang
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea
- Correspondence: ; Tel.: +82-53-620-3316; Fax: +82-53-654-8386
| | - Jung-Gil Park
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea
| | - Hyung-Joo Kim
- Departments of Surgery, Yeungnam University Medical Center, Daegu 42415, Republic of Korea
| | - Joon-Hyuk Choi
- Department of Pathology, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea
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Fasihi Karami M, Beiromvand M, Rafiei A, Dayer D, Rahdar M, Bahreini A, Dastyar AA. Can Echinococcus granulosus-Derived MicroRNAs be Biomarkers for Diagnosis and Follow-up of Cystic Echinococcosis Patients? Acta Parasitol 2023; 68:231-239. [PMID: 36637695 DOI: 10.1007/s11686-022-00654-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 12/13/2022] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Cystic echinococcosis (CE) is a neglected tropical disease caused by the larval stages of Echinococcus granulosus (E. granulosus). MicroRNAs (miRNAs) are small noncoding RNAs acting as mediators in host-parasite interaction. Recently, numerous studies have been conducted on miRNAs in infectious diseases; however, little data are available about the role of miRNAs in pathogenesis and early diagnosis of CE. METHODS The current study evaluated the expression of four E. granulosus-derived miRNAs, including egr-miR-125,5p, egr-let-7,5p, egr-miR-2, and egr-miR-71 in fibrotic and healthy liver tissues of 31 CE patients with active and inactive hydatid cysts by qRT-PCR. RESULTS Of the 31 patients, 48.4% had active cysts (CE1 and CE2), while the remainder had transitional (16.1%) and inactive (35.5%) CE types cysts. The qRT-PCR analysis revealed a significant increase of 11.2, 9.91, 6.2, and 13.1-fold in the fibrotic tissue group for egr-miR-125,5p, egr-let-7,5p, egr-miR-2, and egr-miR-71, respectively. Among these miRNAs, egr-miR-125-5p exhibited the highest area under the curve (AUC) value of 0.8050 for predicting liver fibrosis. CONCLUSIONS Our findings provide new data about the role of E. granulosus-derived miRNAs in pathogenesis of CE. The high AUC of egr-miR125,5p reflecting the possibility of using egr-miR125,5p as biomarker in CE diagnosis. Further studies on serum of CE patients are needed to confirm the potential role of circulating egr-miR-2a-3p and egr-miR-125-5p in the early diagnosis of CE.
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Affiliation(s)
- Maryam Fasihi Karami
- Cellular and Molecular Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Molouk Beiromvand
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Abdollah Rafiei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Dian Dayer
- Cellular and Molecular Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmoud Rahdar
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amin Bahreini
- Department of Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Asghar Dastyar
- Department of Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Karami MF, Beiromvand M, Rafiei A, Dayer D, Rahdar M, Bahreini A, Dastyar AA. Serum Level of egr-miR-2a-3p as a Potential Diagnostic Biomarker for Cystic Echinococcosis. Acta Parasitol 2023; 68:114-121. [PMID: 36434379 DOI: 10.1007/s11686-022-00641-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/03/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Cystic Echinococcosis (CE) is a chronic parasitic disease caused by the metacestodes of Echinococcus granulosus senso lato (E. granulosus s.l.). The larval stages of this parasite, hydatid cyst, are usually diagnosed using imaging modalities and serological testing; however, several studies have recently suggested using the parasite-derived microRNAs (miRNAs) as novel diagnostic biomarkers. MATERIALS AND METHODS The present study included 31 CE patients who were older than 5 years and were admitted to the hospitals of Ahvaz, Iran for hydatid cyst removal surgery during 2019-2021. The egr-miR-125-5p and egr-miR-2a-3p levels were evaluated in the sera of the CE patients before and 6 months after the surgery using Quantitative Real-Time PCR (qRT-PCR), and the results were compared with the serum samples from 15 healthy volunteers. Then, the intergroup comparisons were performed using the t test. RESULTS The patients' age range was 6-72 years, with a mean age of 34.6 years. Moreover, based on the classification by the WHO-IWGE, one patient (3.2%) had CE1, 14 patients (45.2%) had CE2, 5 patients (16.1%) had CE3, 2 patients (6.5%) had CE4, and 9 patients (29%) had CE5. Also, 21 patients (67.74%) had a positive antigen test using the ELISA method, while 10 patients (32.26%) had a negative ELISA. The pre-operative expression level of egr-miR-2a-3p was 10.36 folds higher compared to 6 months after the surgery, with an AUC value of 0.8176. However, the expression levels of egr-miR-125-5p did not change significantly 6 months after the surgery compared to pre-operative levels. CONCLUSIONS According to the present study results, the serum levels of egr-miR-2a-3p can be a promising non-invasive biomarker for diagnosing CE and monitoring its potential recurrence after cystectomy.
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Affiliation(s)
- Maryam Fasihi Karami
- Cellular and Molecular Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Molouk Beiromvand
- Cellular and Molecular Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Abdollah Rafiei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Dian Dayer
- Cellular and Molecular Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmoud Rahdar
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amin Bahreini
- Department of Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Asghar Dastyar
- Department of Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Denzinger M, Nasir N, Steinkraus K, Michalski C, Hüttner FJ, Traub B. [Treatment concepts for hepatic echinococcosis]. CHIRURGIE (HEIDELBERG, GERMANY) 2023; 94:560-570. [PMID: 36853342 DOI: 10.1007/s00104-023-01825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The incidence of both cystic (CE) and alveolar echinococcosis (AE) is increasing in Germany. The CE can often be managed with drug treatment and interventional strategies. In contrast, AE shows characteristics of a malignant disease with a high morbidity and mortality. Benzimidazoles are potent drugs for both entities but with the necessity for a lifelong follow-up and the risk of side effects as well as progression under treatment. Therefore, the indications for surgical resection have to be carefully considered; however, the combination of drug treatment and surgery is the only curative approach. Recently, the use of minimally invasive surgery with reduced morbidity and mortality has justified surgical resection for a broader set of patients; however, minimally invasive surgery requires a high level of expertise and optimal perioperative planning. Therefore, treatment strategies, especially for AE require an individual stratified risk-benefit assessment in an interdisciplinary consensus.
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Affiliation(s)
- Maximilian Denzinger
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland.
| | - Nadir Nasir
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Kira Steinkraus
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Christoph Michalski
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Felix J Hüttner
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
| | - Benno Traub
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Ulm, Albert-Einstein Allee 23, Ulm, Deutschland
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Özdemir M, Türk G, Bilgili M. Percutaneous treatment of giant hydatid cysts: a single-center experience of 58 cysts. Abdom Radiol (NY) 2023; 48:1409-1414. [PMID: 36774554 DOI: 10.1007/s00261-023-03841-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/13/2023]
Abstract
PURPOSE The aim of this study is to evaluate the efficacy of percutaneous treatment in hydatid cysts (HCs) with at least one diameter larger than 10 cm. MATERIALS AND METHODS 58 CE1 or CE3a HCs with at least one diameter larger than 10 cm which were treated with catheterization between September 2016 and December 2021 were retrospectively analyzed. RESULTS Mean age was 40 ± 17.7 (18-80). Majority of HCs were in the liver (89.6%). Median follow-up was 28 months. Technical success rate was 100%; however, a second procedure was needed in 13 cysts due to recollection (n = 4), infection (n = 6), and recurrence (n = 3). CONCLUSIONS Giant HCs can be effectively treated with catheterization with low complication rates.
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Affiliation(s)
- Mustafa Özdemir
- Department of Radiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
| | - Gamze Türk
- Department of Radiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Mustafa Bilgili
- Department of Radiology, Kayseri Education and Research Hospital, Kayseri, Turkey
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Jaén-Torrejimeno I, Ramia JM, López-Guerra D, Rojas-Holguín A, De-Armas-Conde N, Blanco-Fernández G. Textbook outcome in the surgical treatment of liver hydatid cyst. Surgery 2023; 173:429-434. [PMID: 36334979 DOI: 10.1016/j.surg.2022.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Textbook outcome is a composite measure used in surgery to define the ideal postoperative period and to assess the quality of care. The aim of this study was to analyze the incidence of textbook outcome and the factors independently associated with its achievement following surgical treatment of liver hydatid cysts. METHODS Retrospective cohort study of patients operated on for liver hydatid cysts between January 2006 and December 2021. Textbook outcome was achieved when all the following criteria were fulfilled: no mortality within 90 days, no major complications within 90 days, no hospital readmission within 90 days, and no prolonged hospital stay. Univariable and multivariable analyses were performed to identify factors associated with textbook outcome. RESULTS During the study period, 296 patients underwent surgery. Textbook outcome was recorded in 65.9% (195/296). Female gender (odds ratio 2.02; P = .010), noncomplicated cyst (odds ratio 3.97, P < .001), and radical surgery (odds ratio 2.26, P = .003) were the variables associated with a higher probability of achieving textbook outcome. CONCLUSION Textbook outcome may be a useful measure to assess the variations in surgical management between different centers, and to improve quality of care after liver hydatid cysts resection.
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Affiliation(s)
| | - José M Ramia
- Department of Surgery, Hospital Universitario de Alicante, Spain
| | - Diego López-Guerra
- Department of HBP and Liver Transplant Surgery, Hospital Universitario de Badajoz, Spain; Universidad de Extremadura, Facultad de Medicina y Ciencias de la Salud
| | - Adela Rojas-Holguín
- Department of HBP and Liver Transplant Surgery, Hospital Universitario de Badajoz, Spain; Universidad de Extremadura, Facultad de Medicina y Ciencias de la Salud
| | - Noelia De-Armas-Conde
- Department of HBP and Liver Transplant Surgery, Hospital Universitario de Badajoz, Spain
| | - Gerardo Blanco-Fernández
- Universidad de Extremadura, Facultad de Medicina y Ciencias de la Salud; Department of HBP and Liver Transplant Surgery, Hospital Universitario de Badajoz, Spain.
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Acute Abdominal Pain: Peritoneal and Hepatic Hydatidosis. J Emerg Med 2023; 64:224-226. [PMID: 36707346 DOI: 10.1016/j.jemermed.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 10/14/2022] [Accepted: 10/21/2022] [Indexed: 01/26/2023]
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Derakhshani A, Mousavi SM, Rezaei M, Afgar A, Keyhani AR, Mohammadi MA, Dabiri S, Fasihi Harandi M. Natural history of Echinococcus granulosus microcyst development in long term in vitro culture and molecular and morphological changes induced by insulin and BMP-4. Front Vet Sci 2023; 9:1068602. [PMID: 36699324 PMCID: PMC9868913 DOI: 10.3389/fvets.2022.1068602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Cystic echinococcosis (CE) caused by the cestode Echinococcus granulosus is a disease of worldwide public health and economic importance. The determinants and underlying cellular mechanisms of CE development and fate in intermediate hosts are largely unknown. Hormones and cytokines such as insulin and BMP-4 are the key players in the development, differentiation, and apoptosis. In this study, we evaluated the long term natural history of E. granulosus microcysts in an vitro setting and the molecular and morphological changes induced by the growth factors, insulin and BMP4 during the development of metacestode stage of E. granulosus. Methods E. granulosus protoscoleces were cultivated and the parasite development was followed in the long term mono-phasic culture for 105 days and the morphometric, molecular and immunohistochemical changes were evaluated, including the microcysts number and size, microcysts development and deformation rates as well as the markers of calcification (Alizarin Red staining) and apoptosis (BAX, BCL2, Caspase-3, Caspase-8 and TNF-α expression) in the microcysts. Also the biological, histological and molecular consequences of insulin and BMP-4 treatment on the parasite development were evaluated. Results Insulin and BMP-4 treatment of microcysts resulted in significant increase in microcyst formation, increased size, reduced apoptosis and deformation of the microcysts. Alizarin red staining of the microcysts treated with the insulin and BMP-4 confirmed that calcium deposition is significantly lower than the untreated microcysts. Also Alizarin Red staining and Immunohistochemistry of the microcysts indicates that calcium accumulation in deformed microcysts is higher than the normal ones on day 105. The microcysts began to wrinkle and the germinal layer was partially detached from the laminated layer on day 84. Conclusion Results of the present study suggest that the degenerative changes in hydatid cysts can be slowed down by insulin and BMP-4, indicating that cellular factors and host hormones could contribute to the longevity of hydatid cysts. Significant evidences are provided suggesting that the microcysts cultivated in vitro can undergo calcification and apoptotic processes similar to what have been observed in the natural hydatid infection in the intermediate hosts.
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Affiliation(s)
- Ali Derakhshani
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Seyed Mohammad Mousavi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Rezaei
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Afgar
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran,Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Reza Keyhani
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Mohammadi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahriar Dabiri
- Department of Pathology, Afzalipour Medical School, Pathology and Stem Cells Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran,*Correspondence: Majid Fasihi Harandi ✉
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Wang BH, Yin LX, You YJ, Liu J. Uncommon "honeycomb sign" lesions in a middle aged women. Asian J Surg 2022:S1015-9584(22)01788-2. [PMID: 36586818 DOI: 10.1016/j.asjsur.2022.12.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Affiliation(s)
- Bing-Hua Wang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Li-Xue Yin
- Cardiovascular Ultrasound and Non-Invasive Cardiology Department, University of Electronic Science and Technology of China, Sichuan Provincial People's Hospital, Chengdu, 610073, China
| | - Yi-Juan You
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Jun Liu
- Ultrasound Department, University of Electronic Science and Technology of China, Sichuan Provincial People's Hospital, Chengdu, 610072, China.
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Molecular Epidemiology of Cystic Echinococcosis in Rural Baluchistan, Pakistan: A Cross-Sectional Study. Pathogens 2022; 12:pathogens12010040. [PMID: 36678388 PMCID: PMC9863174 DOI: 10.3390/pathogens12010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/09/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
Cystic echinococcosis (CE), or hydatid cyst disease (HCD), is a zoonosis of significant importance caused by the cestode of Echinococcus granulosus sensu lato (s. l.) that affects mainly nomadic populations and has substantial economic consequences. Due to the 76% rural and nomadic population, Baluchistan is a highly endemic region in Pakistan for CE; however, it has not yet been investigated for CE. For this purpose, this study was carried out to investigate the molecular epidemiology of CE in this region. In total, 23 human hydatid cyst samples were collected from tertiary health care units in Baluchistan and processed for DNA extraction, which was then followed by sequencing of the cox1 mitochondrial gene of all 23 collected samples, genotyping, and phylogenetic and haplotype analysis. Most subjects were livestock owners (39.13%) in rural settings (73.91%). Most patients (73.19%) were pet owners (dogs) and used water from open sources for drinking. The liver was the most affected organ (52.17%), followed by the lungs (17.39%). Sequence analysis based on the cox1 gene revealed that EG genotype 1 (G1) was the most prevalent (56.52%), followed by G3 (34.78%), while some samples (8.7%) were identified as the Echinococcus canadensis (G6/7) genotype. A total of five haplotypes were detected with high haplotype diversity (0.80) and low nucleotide diversity (0.033). Phylogenetic analysis revealed two diverse sub-clades, each of G1 and G3 isolates from Baluchistan, that were evolutionarily related to previously reported G1 and G3 isolates from Pakistan and China. On the other hand, the G6/7 isolates of this study were evolutionarily identical to the already reported G6/7 isolates from Pakistan, Turkey, and Kazakhstan. This study concludes that diverse G1 and G3 EG isolates are present in this part of Pakistan, while the G6/G7 genotype was reported for the first time from Baluchistan.
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Kothiya PK, Gupta V, Sarawagi R, Jayashankar E, Sharma J, Wani H, Balaji K, Roshny J. Isolated primary hydatid cyst of the pancreas: Management challenges of a cystic masquerade. Ann Hepatobiliary Pancreat Surg 2022; 26:401-406. [PMID: 35995585 PMCID: PMC9721249 DOI: 10.14701/ahbps.22-031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 12/15/2022] Open
Abstract
Abdominal hydatid cyst disease mostly involves the liver. Involvement of the pancreas as an isolated primary organ is rare accounting for < 2% of all systemic echinococcosis cases. It mostly involves the head of the pancreas. Symptoms depend on the location, size, and associated complications; therefore, it can have varied presentations including acute pancreatitis. On imaging, it can mimic other common pancreatic cystic lesions like pseudocyst or cystic neoplasm. Accurate preoperative diagnosis is usually difficult and requires a very high index of suspicion even in endemic areas. Herein, a case of primary isolated hydatid cyst of the pancreas that was initially diagnosed and managed as acute pancreatic pseudocyst is reported.
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Affiliation(s)
- Pradeep Kumar Kothiya
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Vishal Gupta
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India,Corresponding author: Vishal Gupta, MS, MCh Department of Surgical Gastroenterology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh 462020, India Tel: +917552834086, E-mail: ORCID: https://orcid.org/0000-0003-3574-1805
| | - Radha Sarawagi
- Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Erukkambattu Jayashankar
- Departments of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Jitendra Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Hamza Wani
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Karunagaran Balaji
- Departments of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - J. Roshny
- Departments of Pathology and Laboratory Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
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Liao Y, Zhou G, Yang C, Zhang Y. Uncommon abdominal “egg-shelled” lesions mimic hepatic echinococcosis: Two cases report. Front Surg 2022; 9:944980. [PMID: 36157431 PMCID: PMC9500339 DOI: 10.3389/fsurg.2022.944980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Primary abdominal “egg-shelled” lesions with positive anti-echinococcus IgG antibody were misdiagnosed as echinococcosis. Case presentation Herein we report two cases with primary abdominal “egg-shelled” lesions were misdiagnosed as echinococcosis. Case 1: A 44-year-old woman presented to our department with a history of slight abdominal pain for 4 months. After admission, the laboratory tests indicated a positive anti-echinococcus IgG antibody status. The contrast-enhanced CT scan showed a 12 × 12 cm “me contrast-mass located in the hepatorenal area. The patient had the entire mass and the right adrenal gland resected. This patient recovered smoothly and was discharged uneventfully 20 days after the operation. The pathologic diagnoses was adrenal lymphangioma. Case 2: A 55-year-old woman was admitted with a history of an abdominal mass for over 10 years. After admission, her anti-echinococcus IgG antibody was positive. The contrast-enhanced CT scan revealed a heterogeneous, solid mass measuring 10 × 9 × 8 cm in the right hepatic lobe. A laparoscopic exploration was performed, and the surgery revealed that the mass arose from the retroperitoneal tissue rather than the liver. Finally, the pathologic diagnoses were paraganglioma with necrosis and cystic changes. Conclusion Enhanced CT scan and contrast-enhanced ultrasound scans are important for distinguishing echinococcosis disease from the other “egg-shelled” lesions. Surgical resection is the main treatment method for this disease. Minimally invasive surgery is recommended but should be performed by experienced surgical teams. Immunohistochemical examination is important for the pathologic diagnosis.
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Affiliation(s)
- Yubo Liao
- School of Medicine, Chengdu Medical College, Chengdu, China
| | - Guo Zhou
- Ultrasonography Department, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Chong Yang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province / Organ Transplantation Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Correspondence: Yu Zhang Chong Yang
| | - Yu Zhang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province / Organ Transplantation Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Hepatobiliary and Pancreas Surgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Correspondence: Yu Zhang Chong Yang
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Manterola C, Claros N, Grande L. Postoperative Complications and Recurrence of Abdominal Echinococcosis Rupture: Case Series with Follow-up. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03562-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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50
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Hou X, Shi Y, Kang X, Rousu Z, Li D, Wang M, Ainiwaer A, Zheng X, Wang M, Jiensihan B, Li L, Li J, Wang H, Zhang C. Echinococcus granulosus: The establishment of the metacestode in the liver is associated with control of the CD4+ T-cell-mediated immune response in patients with cystic echinococcosis and a mouse model. Front Cell Infect Microbiol 2022; 12:983119. [PMID: 36046744 PMCID: PMC9422084 DOI: 10.3389/fcimb.2022.983119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
The larval stage of the tapeworm Echinococcus granulosus sensu lato (E. granulosus s.l.) caused a chronic infection, known as cystic echinococcosis (CE), which is a worldwide public health problem. The human secondary CE is caused by the dissemination of protoscoleces (PSCs) when fertile cysts are accidentally ruptured, followed by development of PSCs into new metacestodes. The local immune mechanisms responsible for the establishment and established phases after infection with E. granulosus s.l. are not clear. Here, we showed that T cells were involved in the formation of the immune environment in the liver in CE patients and Echinococcus granulosus sensu strict (E. granulosus s.s.)-infected mice, with CD4+ T cells being the dominant immune cells; this process was closely associated with cyst viability and establishment. Local T2-type responses in the liver were permissive for early infection establishment by E. granulosus s.s. between 4 and 6 weeks in the experimental model. CD4+ T-cell deficiency promoted PSC development into cysts in the liver in E. granulosus s.s.-infected mice. In addition, CD4+ T-cell-mediated cellular immune responses and IL-10-producing CD8+ T cells play a critical role in the establishment phase of secondary E. granulosus s.s. PSC infection. These data contribute to the understanding of local immune responses to CE and the design of new therapies by restoring effective immune responses and blocking evasion mechanisms during the establishment phase of infection.
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Affiliation(s)
- Xinling Hou
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Yang Shi
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Xuejiao Kang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Zibigu· Rousu
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Dewei Li
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Maolin Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Xinjiang Key Laboratory of Echinococcosis, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, and World Health Organization Collaborating Centre on Prevention and Case Management of Echinococcosis, Urumqi, China
- Department of Hepatic Hydatid and Hepatobiliary Surgery, Digestive and Vascular Surgery Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Abidan· Ainiwaer
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Xuran Zheng
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - MingKun Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Bahejiang· Jiensihan
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Xinjiang Key Laboratory of Echinococcosis, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, and World Health Organization Collaborating Centre on Prevention and Case Management of Echinococcosis, Urumqi, China
| | - Liang Li
- Xinjiang Key Laboratory of Echinococcosis, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, and World Health Organization Collaborating Centre on Prevention and Case Management of Echinococcosis, Urumqi, China
| | - Jing Li
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Hui Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Basic Medical College, Xinjiang Medical University, Urumqi, China
- Xinjiang Key Laboratory of Echinococcosis, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, and World Health Organization Collaborating Centre on Prevention and Case Management of Echinococcosis, Urumqi, China
- *Correspondence: Chuanshan Zhang, ; Hui Wang,
| | - Chuanshan Zhang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Basic Medical College, Xinjiang Medical University, Urumqi, China
- Xinjiang Key Laboratory of Echinococcosis, Clinical Medicine Institute, The First Affiliated Hospital of Xinjiang Medical University, and World Health Organization Collaborating Centre on Prevention and Case Management of Echinococcosis, Urumqi, China
- *Correspondence: Chuanshan Zhang, ; Hui Wang,
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